Dynesys 系统治疗腰椎退变不稳 35 例疗效分析简

目的总结Dynesys动态稳定系统治疗腰椎退变性疾病的疗效。方法自2007—10--2009-01应用Dynesys系统治疗腰椎退变导致的腰腿痛患者35例，对患者术前及术后进行ODI脊髓功能评分，术前及随访期间拍摄腰椎正侧位、过伸过屈位X片及MRI。结果所有患者术后随访2～5年，平均38．2个月，术后患者ODI评分均改善，术前为（56．76±9．11）％。术后6个月时为（13．52±10．23）％，末次随访时为（13．41±12．41）％，术前与术后的ODI评分差异有统计学意义（P〈0．05）．术后各时间点差异无统计学意义（P〉0．05）。k、，节段活动度（ROM）术前、术后6个月、术后1年及末次随访分别为（13．53±2．19）°、（2．35±1．05）°、（2．36±1．10）°和（2．45±1．13）°，L5S1节段的ROM分别为（10．20±2．24）°、（2．10±1．37）°、（2．24±1．30）°和（2．52±1．59）°。结论Dynesys动态稳定系统作为一种预防及治疗腰椎退变疾病的装置，可以保留腰椎被固定节段轻微的活动度，其对相邻节段椎间盘退变和运动未见明显影响。

Clinical observation of Dynesys in treatment of 35 cases of lumbar degenerative instability disease

Objective To summarize efficacy of treating lumbar degenerative diseases with Dynesys dynamic stabilization system. Methods From Oct. 2007 to Jan. 2009, 35 cases of low back and leg pain due to lumbar degeneration were treated with Dynesys system. The parameters of ODI score, X-rays and MRI were given pre- and postoperative. Results The mean follow-up period was 38.2 months （2 to 5 years）. The ODI score was improved from （56.76-±9.11）% preoperative to （13.52-± 10.23）% at 6 months after surgery and （13.41-±12.41）% at the final follow-up, there were significant differences in ODI scores between pre- and postoperative （P 〈0.05）. However, there were no significant differences in ODI scores among each time point （P 〉0.05）. L4,5 vertebral segments of the activity （ROM） at preoperative, 6 months and 1 year postoperative, and the final follow-up were （13.53±2.19）°, （2.35±1.05）°, （2.36±1.10）° and （2.45±1.13）° respectively, L5S1 segment ROM were （10.20± 2.24）°,（2.10-±1.37）°, （2.24±1.30）± and （2.52±1.59）° respectively. Conclusion Dynesys dynamic stabilization system is placed as a prevention and treatment method for lumbar degenerative diseases, which keep segment of the lumbar spine fix slight activity and has no obvious effect on the adjacent segment disc degeneration and motion.