Wallis棘突间动态稳定系统治疗腰椎管狭窄症的临床疗效观察

Dynamic stabilization system between Wallis spines treatment the clinical effect of the treatment onlumbar spinal stenosis

目的探讨Wallis棘突间动态稳定系统（简称WaUis系统）治疗腰椎管狭窄症的临床疗效。方法2010年10月-2012年5月，应用Wallis系统治疗腰椎管狭窄症27例。观察手术时间、出血量、术后住院时间、术后并发症，比较术前、术后1周、术后3个月、1年随访时下腰痛JOA评分、腰腿痛VAS评分、Oswestry功能障碍指数情况（ODI）及x线片上手术节段椎间隙高度（intervertebraldischeight，IDH）变化。结果平均手术时间70min，术中出血量100ml，术后住院时间4d，术后未发现假体移位、棘突骨折等并发症。所有患者术后症状明显改善，术后1周、3个月及1年随访时下腰痛JOA评分、腰腿痛VAS评分、Oswestry功能障碍指数情况（ODI）与术前比较均有统计学差异（P〈0．01）。术后1周随访时手术节段椎间隙与术前相比有统计学差异（P〈0．01），术后3个月及1年随访时手术节段椎间隙与术前相比无统计学差异（P〉0．05）。结论Wallis系统治疗腰椎管狭窄症，创伤小、恢复快，临床效果满意，为腰椎管狭窄疾病的手术治疗提供了一种新的选择。

Objective To study the clinical curative effect of dynamic stability system between the WaUis spine （hereinafter referred to as WaUis system） oon lumbar spinal stenosis. Methods From October 2010 to May 2012, Wallis system was adopted for treatment of lumbar spinal stenosis in 27 cases. The surgical duration, blood loss, postoperative hospitalization length, postoperative complications was recorded. The JOA score of low back pain, VAS score of lumbocrural pain, oswestry disability index （ODI）, and the change of the intervertebral height of the surgery- corrected segment prior to surgery, 1 week, 3 week, 1 year after surgery were analyzed and compared. Results The average surgical duration was of 70 min （50-130 min）, intraoperative blood loss 100 ml （30-250 ml）, postoperative hospitalization length 4 days （3-7 days）. No prosthetic complication such as shift, spine fractures was found postoperatively. Preoperative symptoms were reduced in all patients. Improvement was found in JOA score of low back pain, VAS score of lumbocrural pain, oswestry disability index （ODI） at 1 week postoperative, 3-month and 1-year follow-up when compared with those preoperatively. （P 〈 0.01）. The intervertebral height of the surgery-corrected segment was larger at 1 week postoperatively than that prior to surgery. （P〈0.01）. No statistical significance was found in the intervertebral height of the surgery-corrected segment at 3-month and 1 year follow-up（P〉0.05）. Conclusion Little trauma, quick recovery, satisfactory clinical effect can be achieved y Wallis system for treatment of lumbar spinal stenosis, providing a new option.