Division of Special Surgery, Instituto Nacional de Rehabilitación, Mexico Distrito Federal, Mexico.
Eur Spine J. 2010 Dec;19(12):2164-70. doi: 10.1007/s00586-010-1417-7. Epub 2010 May 22.
Decompression surgery for lumbar spinal stenosis is a common procedure. After surgery, segmental instability sometimes occurs, therefore, different methods for restabilization have been developed. Dynamic stabilization systems have been designed to improve segmental stability. In this study, clinical results of patients with lumbar spinal stenosis that underwent decompression and stabilization with the Accuflex dynamic system are presented; clinical, radiographic, and magnetic resonance imaging (MRI) findings are fully described. Improvements in all clinical measurements, including visual analog scale for back and leg pain, Oswestry disability index, and SF-36 health status survey were noticed. At a 2-year follow-up, 22.22% of patients required hardware removal due to fatigue while in 83% of them no progression of disk degeneration was observed after implantation of the Accuflex system. Additionally, as demonstrated by the MRI images at follow up, three patients (16%) showed disk rehydration with one grade higher on the Pfirmann classification. Although a relatively high hardware failure was observed (22.22%), the use of the dynamic stabilization system Accuflex posterior to decompression procedures, showed clinical benefits and stopped the degenerative process in 83% the patients.
腰椎管狭窄症的减压手术是一种常见的手术。手术后,节段性不稳定有时会发生,因此,已经开发了不同的稳定方法。动态稳定系统被设计用来改善节段稳定性。在这项研究中,介绍了接受 Accuflex 动态系统减压和稳定治疗的腰椎管狭窄症患者的临床结果;充分描述了临床、影像学和磁共振成像 (MRI) 发现。所有临床测量的改善,包括腰背腿痛的视觉模拟量表、Oswestry 残疾指数和 SF-36 健康状况调查,都得到了注意。在 2 年的随访中,由于疲劳,22.22%的患者需要去除硬件,而在植入 Accuflex 系统后,83%的患者没有观察到椎间盘退变的进展。此外,正如随访时的 MRI 图像所示,3 名患者(16%)表现出椎间盘再水化,Pfirrmann 分级高 1 级。尽管观察到相对较高的硬件失败(22.22%),但在减压手术后使用 Accuflex 动态稳定系统显示出了临床益处,并阻止了 83%的患者的退行性过程。