腰椎棘突间动态稳定装置治疗腰椎间盘退变性疾病的中期疗效观察

Medium-term efficacy of lumbar interspinous dynamic stabilization device on treatment of lumbar degenerative diseases

目的观察腰椎棘突间动态稳定装置(Wallis系统)治疗腰椎退变性疾病的中期疗效。方法回顾性分析2008年2月至2010年10月应用第二代Wallis系统治疗34例腰椎退变性疾病患者的中期疗效。通过比较患者术前、术后3月和末次随访的疼痛视觉视觉模拟量表评分、下腰痛日本骨科协会评分,计算JOA改善率评估手术疗效;通过腰椎侧位X线片测量手术节段椎间盘平均高度及腰椎动力位X线片测量病变相邻节段椎体间活动范围的变化,评价腰椎稳定性的变化。结果 31例患者经26～38个月随访,VAS评分末次随访较术前有显著下降(P<0.05),较术后3个月无明显改变(P>0.05);JOA评分末次随访较术前有显著上升(P<0.05),较术后3个月无明显改变(P>0.05)。DH值及ROM值末次随访较术前和术后3个月均无明显改变(P>0.05)。结论 Wallis系统治疗椎间盘退变性疾病能缓解症状、延缓置入节段高度丢失和维持椎间稳定。

Objective To evaluate the medium-term efficacy of lumbar interspinous dynamic stabilization device （the Wallis system） on treatment of lumbar degenerative diseases. Methods Retrospective analysis the curative effect of 34 patients who use second generation Wallis system to treat lumbar degenerative disease from February 2008 to October 2010. The visual analogue scale （VAS） and Japanese Or- thopaedic Association （JOA） scores were recorded before operation,3 months after operation,and at the last follow-up so as to evaluate the curative effect. The operative segment disc height （DH） and range of motion （ROM） of adjacent segment were evaluated preoperatively, post- operatively and at the last follow-up. Results 31 patients were followed up for 26 to 38 months, VAS scores at the last follow-up significantly decreased compared with scores in preoperation （P 〈 0.05 ） , but there was no significant difference compared with scores 3 months after operation. JOA scores at the last follow-up siguificantly increased cpmpare with preoperation （P 〈 0.05 ） , and there was no siguificant change compared with scores 3 months after operation （ P 〉 0.05 ）. The DH and ROM of the last follow-up compared with data before and 3 months after operation showed no significant change （ P 〉 0.05 ）. Conclusion Wallis system is of good curative effect in the treatment of degenerative disc disease. It can be used to alleviate the symptoms, delay in segmental height loss and maintain spinal stabilization.