Wallis动态稳定系统治疗退行性腰椎失稳症的长期随访研究

目的评价腰椎后路棘突间Wallis动态稳定系统治疗退行性腰椎失稳症的长期临床疗效。方法 2007年10月至2011年10月,我科应用Wallis动态稳定系统治疗退行性腰椎失稳症患者25例,其中男性5例,女性20例,平均年龄54.8岁(43⁶5岁)。均为后路手术。19例单节段,5例2节段(3例L4/5、L5/S1,2例L3/4、L4/5),1例3节段(L1/2、L4/5、L5/S1)手术,15例同时行减压手术,4例同时行腰椎间盘摘除术。收集术前与术后6个月、术后2年的疼痛视觉评分(VAS评分)、下腰痛JOA评分及Oswestry功能障碍指数(ODI),予以统计学分析。结果术后成功随访2年以上患者20例,随访平均28.6个月(2465岁)。均为后路手术。19例单节段,5例2节段(3例L4/5、L5/S1,2例L3/4、L4/5),1例3节段(L1/2、L4/5、L5/S1)手术,15例同时行减压手术,4例同时行腰椎间盘摘除术。收集术前与术后6个月、术后2年的疼痛视觉评分(VAS评分)、下腰痛JOA评分及Oswestry功能障碍指数(ODI),予以统计学分析。结果术后成功随访2年以上患者20例,随访平均28.6个月(24⁴4个月),Wallis动态稳定系统固定可靠,无捆绑带松弛、断裂、无后凸畸形。术后6个月、2年的VAS评分及ODI评分均较术前显著降低(P<0.05);术后6个月及2年的JOA评分较术前显著增加(P<0.05)。结论 Wallis动态稳定系统治疗退行性腰椎失稳症有良好的长远期临床疗效,值得推广。

Long-term Follow-up Research of Wallis Dynamic Stabilization System in Treatment of Degenerative Lumbar Segmental Instability

Objective To evaluate long-term clinical outcome of Wallis dynamic stabilization system in treatment of degenerative lumbar segmental instability. Methods From Oct 2007 to Oct 2011 25 degenerative lumbar segmental instability patients were treated with Wallis dynamic stabilization system. There were 5 Male, 20 Female, age 54.8ys＇（43-65ys＇）. There were 19 cases of single level, 5 cases of double levels（3 cases of L4/5, L5/S1, 2 cases of L3/4, L4/5）, 1 case of three-level（L1/2, L4/5, L5/S1）. 15 cases of decompression and 4 cases of discectomy were preformed at the same time. Pre-operation, 6 month and 2 year post operation Visual analogue scale（VAS）and Japanses Orthopedic Association（JOA）scores of low back pain and Oswestry disability index（ODI）were collected and analyzed. Results 20 patients were successfully follow-up for 2 years, mean 28.6 m（24-44 m）. Wallis dynamic stabilization system was reliable. There was no loosening, implant disrupt and kyphosis. Significant differences between pre-operative and 6 month post-operation, pre-operative and last follow-up data of all groups were discovered（P〈 0.05）. Conclusion Wallis dynamic stabilization system in treatment of degenerative lumbar segmental instability has long-term favorable clinical outcomes.