Dynesys动态稳定系统治疗腰椎多节段退变性疾病  

Clinical application of Dynesys system for treatment of multiple lumbar degenerative disease

作　　者：庞晓东[1] 杨洪[1] 陈希霞[1] 高春华[1] 李端明[1] 彭宝淦[1] 

机构地区：[1]北京武警总医院脊柱外科,北京100039

出　　处：《脊柱外科杂志》2014年第1期11-14,共4页Journal of Spinal Surgery

摘　　要：目的 探讨Dynesys 动态稳定系统在腰椎多节段退变性疾病治疗中的临床疗效.方法回顾性分析2009 年7月～2012年7月采用Dynesys动态固定系统治疗的多节段腰椎退变性疾病患者30例.其中男10例,女20例;年龄为30～64岁,平均49.2岁.患者中腰椎退变性侧凸L2/L3/L4/L5/S1 1例;腰椎椎管狭窄症16例,L1/L2/L3/L4/L5 1例,L2/L3/L4/L5/S1 1例,L3/L4/L5 3例,L4/L5/S111例; 椎间盘突出症13例,L4/L5 椎间盘突出合并L5/S1退变5例,L5 /S1椎间盘突出合并L4/L5退变4例,L4/L5/S1 双节段突出者4例.临床症状包括下腰痛、下肢放射痛以及间歇性跛行.所有患者均有腰痛和/或腿痛的症状,经非手术治疗＞3个月无效.术前腰椎疼痛视觉模拟量表（ visual analogue scale,VAS） 评分为6.30分（3～9分）,腿痛VAS评分6.40分（ 0～9分）,Oswestry功能障碍指数（Oswestry disability index,ODI）为62.67%.测量术后末次随访时患者腰痛、腿痛的VAS评分及ODI.结果 患者随访12～48个月,平均25个月.患者腰痛VAS评分在末次随访时较术前有明显的降低（1.77分）,腿痛VAS评分也较术前有明显的降低（1.36分）,ODI较术前也有明显的降低（12.50%）.与术前相比,差异均有统计学意义（ P＜0.05）.结论 Dynesys 动态固定系统手术操作简单、易掌握,可避免融合术相关并发症,效果满意.其长期临床疗效还需长时间临床观察.Objective To explore the clinical efficacy of Dynesys system for treatment of multiple segment lumbar degener- ative disc disease. Methods A total of 30 patients （ 10 males and 20 females） with lumbar degenerative disc disease treated with Dynesys system from July 2009 to July 2012 were retrospectively reviewed. There were 1 case having degenerative scolio- sis, 16 cases having lumbar canal stenosis and 13 cases having lumbar disc herniation. The mean preoperative visual analogue scales（VAS） score was 6.3 （ 3-9 ） for the low back pain and 6.4 （ 0-9 ） for the leg pain, and the mean Oswestry disability index （OD1） was 62.67%. Results The mean follow-up period of all patients was 25 months. The postoperative VAS score of the low back pain was significantly reduced compared with the preoperative one （ P 〈 0.05 ）. The same reduction was also noticed in leg pain VAS score and ODI （ P 〈 0.05 ）. Conclusion Dynamic fixation system Dynesys is simple and easy to master, and it can avoid fusion surgery-related complications. The clinical results is satisfactory. However, its long-term clini- cal efficacy should be verified with long time.

关 键 词：腰椎 腰痛 椎管狭窄 椎间盘移位 内固定器 

分 类 号：R681.533[医药卫生—骨科学]