【作者】 杨述华； 许伟华； 叶树楠； 冯勇； 吴星火； 刘先哲； 王晶；

【Author】 Yang Shu-hua XU Wei-hua,Ye Shu-nan,et al.Yong Feng,Department of Orthopaedics,Union Hospital, Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China

【机构】 华中科技大学同济医学院附属协和医院骨科；

【摘要】 目的:探讨后路动态稳定系统(dynamic neutralization system,简称Dynesys)在腰椎退行性疾病的应用指征、疗效和安全性。方法:2007年1月至2008年12月,对35例退行性腰椎疾患患者在后路减压并同时行Dynesys内固定术。男13,女22例;年龄37～60岁,平均48岁。其中腰椎间盘突出并退行性椎管狭窄27例,椎间盘退行性改变6例,腰椎间盘突出术后症状再发2例。应用VAS进行疼痛评估;以Oswestry功能丢失指数进行临床疗效评价。结果:随访时间6～24个月(平均14个月),VAS(0-10)评分:术前9.6-6.7,平均8.6,术后0-5.1平均2.9;Oswestry术前32-83分(平均66分):术后0-62分(平均34),无钉绳系统和聚脂套管松动。按中华医学会骨科学分会脊柱学组腰背痛手术评定标准评价:优25例,良7例,可3例,症状改善优良率达91%。结论:Dynesys可保留固定节段的活动度,且临床症状恢复可靠,是治疗腰椎退行性疾病的一种有效的非融合性、动力性固定方法。更多还原

【Abstract】 Objective:The aim of the present study was to assess the indication safety and efficacy of the dynamic stabilization system in the treatment of degenerative lumbar diseases.Methods From January 2007 to December 2008,35 consecutive patients with lumbar degenerative disease were included in this study.There were 13 males and 22 females,with average age of 48 years(range 37-60 years).The diagnoses included degenerative spinal stenosis 27 cases,degenerative lumbar discs 6 cases and recurrent intervertebral lumbar disc herniation 2 cases.Results The mean follow-up period was 14 months(range 5-24 months).The VAS decreased from preoperative score of 8.6(9.6 to 6.7) to postoperative one of 2.9(0 to 5.1),and the patients’ Oswestry disability index was improved from preoperative score of 66(32 to 83) to postoperative one of 34(0 to 62).There were no patients with implant failure.According to clinical outcome judgement criterion of surgical treatment for low back pain formulated by the spine group of Chinese Orthopaedic Association,excellent in 25cases,good 7 cases,fair 2 cases,poor 1 case,the excellent and good rate was 91%.Conclusion The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability.更多还原