【摘要】 [目的]评价Dynesys动态稳定系统的临床效果。[方法]本研究共纳入在2008年12月~2010年3月期间行Dynesys系统治疗的患者21例,评价指标主要包括VAS、JOA与ODI评分,以及对术前、末次随访时的腰椎正侧位、动力位X线片进行椎间角度测量,并计算椎间角度位移(ROM)。[结果]末次随访时的VAS评分及ODI均较术前显著降低(P<0.01),JOA评分则显著升高(P<0.01)。各疗效指标(VAS、JOA及ODI改善率)与所研究的影响因素间无明显相关性(P>0.05)。不同体位、不同节段的椎间角度在术前与末次随访时无明显差异(P>0.05),末次随访时手术节段ROM较术前显著减少(P<0.01),上位及下位节段的术前ROM与末次随访ROM比较,均无显著差异(P>0.05)。[结论]随访的结果显示Dynesys的疗效较佳,且疗效没有受到所研究因素的影响。Dynesys对于手术节段起到了应有的固定作用,节段的活动度受到了部分限制,但保持了一定程度的可活动性。另一方面,仅就椎间活动度变化的现状来看,Dynesys在保持了手术节段一定活动度的同时,又没有增加手术节段及邻近节段的退变。更多还原

【Abstract】 [Objective]To investigate the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. [Methods]The study population included 21 consecutive patients who underwent decompression and dynamic stabilization with the Dynesys system between December 2008 and March 2010.All the patients completed the visual analogue scale(VAS),the Japanese Orthopedic Association(JOA) Scale and the Chinese version of the Oswestry Disability Index(ODI) at admission and final follow-up.The following radiological parameters were measured in all patients:stabilized segments intervertebral angle,apper and lower adjacent segments intervertebral angles.The range of motion(ROM) was then calculated.[Results]Compared with preoperation,the postoperative VAS and ODI decreased significantly(P<0.001),and the JOA scale improved(P<0.001).But the correlation between outcome measures(VAS,JOA and ODI) and factors was not significant(P>0.05).Furthermore,there were statistically significant changes in the ROM at the stabilized segments(P<0.001),but no significant changes were seen at the adjacent segments(upper and lower segments,P>0.05).[Conclusion]The results of this study show that the Dynesys system instrumentation have good efficacy in clinical application,which is mainly determined by the instrumentation itself.The Dynesys provides firm fixation while preserving the motion of stabilized segments.In the other hand,in view of the notion of adjacent segments,the Dynesys instrumentation does not accelerate the degeneration of the adjacent segments.更多还原