Wallis棘突间动态稳定系统的初步临床应用

目的:探讨Wallis棘突间动态稳定系统(简称Wallis系统)治疗腰椎间盘退变性疾病的初步临床效果.方法:2008年4月～2008年10月,应用Wallis系统治疗腰椎间盘退变性疾病18例.观察其病变节段手术前后的活动范围(range of motion,ROM)和椎间盘后高度(posterior disc height,PDH)的变化、患者手术前后疼痛的视觉模糊评分(visual analogue scale,VAS)、下腰痛JOA评分以及Oswestry功能障碍指数(Oswestry Disability Index,ODI).结果:手术时间(81.1±4.9)min(55～125 min),术中出血量(70±9.2)ml(30～200 m1).术后随访6～12个月,平均9.50±0.41.术前、术后2周内和术后6个月PDH:(10.01±0.43)、(11.99±0.39)和(10.44±0.36)mm.患者术前与术后2周的PDH有明显差别(P<0.05)、与术后6个月PDH则无显著差异(P=0.209 ).术前、术后ROM值分别为:(23.69±2.58)°、(18.35+1.39)°,术后活动度明显减小(P<0.05).术前与术后6个月患者VAS评分、JOA评分、ODI相比较均具有统计学差异(P<0.05).结论:Wallis系统是治疗腰椎间盘退变性疾病的一种安全、有效的外科方法,其远期效果有待进一步观察.

Preliminary clinical result of the Wallis dynamic stabilization system

Objective: To explore the efficiency of the Wallis dynamic stabilization system in treatment of lumbar degenerative disc diseases(DDD). Methods: 18 cases of DDD were treated with the Wailis system from April 2008 to October 2008,including 13 male and 5 females with average age of (43.94±2.44) years. The VAS,JOA and ODI were scored to evaluate the clinical efficiency. The ROM and PDH of the L4/5 level were also recorded to assess the biomechanicai change before and after operation. Results: The mean operation time was about (81.11±4.99) min and mean volume of blood loss (70.00±9.20) mL The PDH of L4/5 was significant elevated in 2 weeks post-operatively (P<0.05),but had no statically difference at 6 months after operation when comparing to that of pre-operative level (P=0.209). The ROM of L4/5 level had a significant difference between pre-operation and 6 months post-operation (P<0.05). There was a significant improvement in the VAS,JOA Scores and ODI scores between pre-operation and post-operation (P<0.05). Conclusions: The preliminary clinical results show the Wallis system is a safe and effective new technique in treatment of lumbar disc degenerative disease.