Dynesys动态固定系统在腰椎退行性病变中的应用

Application of Dynesys dynamic fixation system in treatment of lumbar degenerative disease

目的探讨后路动态稳定系统(Dynesys)治疗腰椎退行性病变的手术方法及临床疗效。方法收治的腰椎退行性病变患者56例分为传统腰椎融合手术组(传统组)和Dynesys动态非融合组(Dynesys组),每组28例。观察2组患者的手术时间、术中出血量,术前与术后12个月、24个月的疗效、VAS疼痛评分、Oswestry功能障碍指数(ODI)变化。结果 Dynesys组的手术时间、术中出血量均显著高于传统主组(P<0.05)。Dynesys组和传统组术后12个月、24个月的VAS、ODI评分较术前组内比较均显著下降(P<0.05);Dynesys组术后12个月、24个月的VAS、ODI评分较传统组下降更加明显(P<0.05)。Dynesys组的疗效显著优于传统组(P<0.05),Dynesys组的总有效率高于传统组,但差异无统计学意义(P>0.05)。结论采用后路动态稳定系统(Dynesys)治疗腰椎退行性病变较传统方法手术时间短,出血量少,术后效果更理想,值得临床应用推广。

Objective To investigate the operation method and clinical effect of posterior dynamic neutralization system（ Dynesys） in treatment of lumbar degenerative disease.Methods By means of random digits table,56 patinets with lumbar degenerative disease who were admitted into our hospital from February 2010 to April 2012 were divided into the traditional lumbar fusion operation group（ traditional treatment group） and Dynesys dynamic non-fusion group（ Dynesys group）,with 28 patients in each group.The operation time,hemorrhage volume during operation,the therapeutic effects before operation and after 12-month,24-month treatment,VAS pain score,Oswestry disability index（ ODI） were observed and analyzed for both groups.Results The operation time,hemorrhage volume in Dynesys group were significantly higher than those in traditional treatment group（ P〈0.05）.The VAS,ODI score after 12-month,24-month treatment were significantly decreased in both groups,as compared with those before treatment（ P〈0.05）,moreover,which in Dynesys group were much more significantly decreased,as compared with those in traditional treatment group（ P〈0.05）.The therapeutic effects in Dynesys group were superior to those of traditional treatment group（ P〈0.05）.The total effective rate in Dynesys group was higher than that in traditional treatment group,however,there was no significant difference between two groups（ P〈0.05）.Conclusion The posterior dynamic stabilization system（ Dynesys） is superior to traditional operation method in treatment of lumbar degenerative disease,with shorter operation time,less hemorrhage volume,more satisfactory postoperative effect,so which is worthy of clinical application.