Dynesys动态固定系统治疗腰椎退变性疾病的临床疗效

Clinical observation on therapeutic effect of Dynesys dynamic neutralization system for degenerative lumbar spine disease

目的探讨Dynesys动态固定系统应用于退变性腰椎疾病中的临床疗效评价。方法自2009-01—2013-01采用Dynesys动态固定系统结合后路椎板减压治疗35例腰椎退变性疾病,包括腰椎间盘突出症23例,腰椎管狭窄症12例。结果术后随访时间为6~40个月,平均26个月。术后3个月、1年和末次随访时的VAS及ODI均较术前明显下降,差异有统计学意义(P<0.05),而末次随访时较术后3个月和1年继续下降,差异有统计学意义(P<0.05)。手术节段椎间隙后缘高度较术前明显增加,差异有统计学意义(P<0.05),但随时间的延长,高度略有下降,椎间隙前缘高度较术前减少,但差异无统计学意义(P>0.05)。手术节段保持了一定的活动度,但较术前明显减少,差异有统计学意义(P<0.05)。结论 Dynesys动态固定系统结合椎板减压治疗腰椎退变性疾病的早期效果较明显。该手术方案维持了手术节段的椎间隙高度,在稳固脊柱的前提下保留一定活动度,能够预防邻近节段退变及腰椎不稳,但远期的疗效还需进一步深入研究。

Objective To evaluate the clinical efficacy of Dynesys neutralization system in the treatment of degenerative lumbar disease. Methods From January 2009 to January 2013,35 consecutive patients with degenerative lumbar spine diseases underwent posterior decompression and internal fixation with the Dynesys dynamic neutralization system. The series of cases were composed of 23 cases of lumbar disc herniation, 12 cases of spinal stenosis. Results All patients were followed up for an average of 26 months （range, 6-40 months ） .The postoperative VAS and ODI score decreased significantly （P 〈0.05） compared with preoperative counterpa^s. The posterior disc space height increased significantly up to 1 year after operation （P 〈0.05）,which had the tendency of decrease with time progressing. The anterior disc space height did not change significantly（P 〉0.05） while the range of motion at surgical level decreased through the entire foUow-up（P 〈0.05）. Conclusion Early outcome were excellent with the Dynesys dynamic stabilization system decompression for degenerative lumbar spinal stenas. It can maintain disc height, which reserve the range of motion of stabilized segments, prevent degeneration of adjacent segments and avoid instability. However its long-term outcome needs to be further investigated.