【摘要】 目的评价腰椎棘突间Wallis非融合固定装置治疗退变性腰椎失稳症的临床效果。方法回顾性分析自2007年10月～2010年12月收治的36例腰椎失稳症的临床资料。观察手术前后疼痛视觉评分(VAS)、下腰痛JOA评分、Oswestry功能障碍指数(ODI)及置入节段的活动范围(ROM)和椎间盘后缘高度(PDH)的变化。结果随访3~44个月,平均20.3个月。平均手术时间85.4 min(60~150 min),术中平均出血量95 ml(50~350 ml)。术后末次随访时VAS评分为(3.3±1.0)分,下腰痛JOA评分为(26.3±4.8)分,ODI评分为(23±12.4)%,与术前比较差异有统计学意义(P<0.05)。术后手术节段的ROM(5.2±3.5)°与术前相比明显减少(P<0.05)。术后手术节段的PDH(8.8±2.5)mm较术前明显增加(P<0.05)。结论采用棘突间Wallis非融合固定装置手术治疗腰椎失稳症能够取得比较满意的临床效果。更多还原

【Abstract】 Objective To evaluate the efficiency of interspinous implantation of Wallis non-fusion devices in surgical treatment of degenerative lumbar segmental instability.Methods From October 2007 to December 2010,36 cases of lumbar segmental instability were treated with posterior interspinous implantation of Wallis non-fusion devices.Visual Analogue Scale(VAS),JOA(Japanese Orthopaedics Association) score for low back pain and Oswestry Disability Index(ODI) were used to evaluate clinical outcomes.In addition,the range of motion(ROM) and posterior disc height(PDH) at the instrumented level were also measured to assess radiological outcomes between before and after operation.Results The average follow-up was 20.3 months(3 ~44 months).Mean operation timing and blood loss were 85.4 min(60 ~150 min) and 95 ml(50 ~350 ml) respectively.At the last follow-up,the VAS score,JOA score and ODI were(3.3±1.0),(26.3±4.8) and(23±12.4)% respectively,all with P <0.05.The symptoms remarkably improved.At last follow-up,the ROM of instrumented segments and the PDH were(5.2±3.5)° and(8.8±2.5)mm respectively,both with P <0.05.Conclusion Good clinical results could be achieved by surgical intervention with Wallis non-fusion devices in treatment of lumbar vertebrae instability.更多还原