Dynesys治疗腰椎退变性疾病的短期疗效观察

目的总结Dynesys动态稳定系统置入治疗早期腰椎退变性疾病的短期疗效。方法应用Dynesys系统治疗因腰椎退变致腰腿痛患者17例，手术保留节段棘突和韧带，摘除突出的责任椎间盘，行椎管减压或潜凿式减压解除神经根管狭窄，将聚乙烯带安置于椎弓根钉之间。对患者术前及术后进行JOA脊髓功能评分。术后平均随访9个月（3～15）个月，手术前及随访期间拍摄脊柱正侧住X片及MRI。结果17例疗效评价均为优，JOA评分15～18分，平均16．5分。结论Dynesys动态稳定系统置入可以保留腰椎被固定节段的活动性、解剖结构的完整性，同时维持节段稳定性，促进退变椎间盘的恢复，并通过保留手术节段脊柱运动功能而预防相邻节段椎间盘退变，有良好的临床效果。

Early clinical observation of Dynesys in treatment of lumbar degenerative disease

Objective To summarize the early experience of the implantation of Dynesys posterior dynamic stabili- zation system for the treatment of early lumbar degenerative disease. Methods during October 2007 to January 2009,17 patients with backleg pain were treated with Dynesys. The Dynesys was implanted after the excision of herniated disk and the decompression of vertebral canal with the intact spinous process and ligament. The JOA was given before and after the operation. The patients were followed up for average 9 months after the operation. Resnlts The evaluation of thera- peutic effect was excellent. JOA score were 15-18 with the average of 16.5. The MRI showed that no compression of spi- nal cord and improvement of disc signal. The degeneration of the proximal disc did not aggravate. Conclusion The Dyne- sys posterior dynamatic stabilization system, as a non-rigid fixation technique, can preserve the mobility, anatomy and stability of operated lumbar vertebral bodies, promote the recover of the lesion discs, and prevent the degeneration of adjacent discs.