棘突间非融合技术在椎间盘源性腰痛中的应用

目的总结棘突间动态稳定系统Wallis治疗椎间盘源性腰痛(discogenic low back pain,DLBP)的中短期临床效果。方法观察2007年～2010年应用Wallis棘突间稳定系统治疗的35例DLBP患者手术前后腰部痛视觉模拟量表(visual analogue scale,VAS)评分,Oswestry功能障碍指数(Oswestry disability index,ODI),病变节段手术前后的活动范围(range of motion,ROM)及椎间隙高度(disc height,DH)的变化。结果所有患者平均随访30个月。腰痛VAS评分由术前的(7.83±1.42)分降至随访时的(2.43±1.33)分,ODI由术前的(66.24±11.38)%减至随访时的(25.69±10.33)%,差异均有统计学意义(P<0.05)。DH术前(9.01±0.59)mm,随访时(9.19±0.53)mm,差异有统计学意义(P<0.05)。ROM由术前的16.3°±1.4°减少到随访时的12.3°±1.3°,差异有统计学意义(P<0.05)。结论 Wallis棘突间动态稳定系统治疗DLBP的中短期疗效满意,能较好地恢复手术节段DH,减少手术节段ROM,预防腰椎不稳,远期疗效尚需进一步随访。

Application of Wallis dynamic stabilization system for treatment of Discogenic low back pain

Objective To explore the short-to-middle term efficiency of the Wallis dynamic stabilization system in treatment of discogenic low back pain（DLBP）.Methods A total of 35 DLBP patients were treated with the Wallis system from 2007 to 2010,including 11 males and 24 females,with and average age of 47.3 years.The visual analogue scale（VAS） and Oswestry disability index（ODI） were scored to evaluate the clinical efficiency.The disc height（DH） and range of motion（ROM） were also recorded to assess the changes before and after operation.Results All the patients were followed up for 30 months.The VAS score decreased from（7.83±1.42） before operation to（2.43±1.33） after operation,and the ODI decreased from（66.24±11.38）% before operation to（25.69±10.33）% after operation,both showing significant differences（P0.05）.The DH increased from（9.01±0.59）mm before operation to（9.19±0.53）mm after operation（P0.05）.The ROM decreased from 16.3°±1.4° to 12.3°±1.3° after operation（P0.05）.Conclusion The short-to-middle term efficiency of the Wallis dynamic stabilization system is satisfactory in treatment of DLBP;it can better restore the DH and reduce the ROM of the involved segment,so as to prevent instability,but the long term efficiency of the system needs further study.