Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 2010 Nov;123(21):2974-7.
The Dynamic Interspinous Assisted Motion (DIAM) system was designed to stabilize degenerative spinal segments without fusion surgery, maintain segment motion and prevent adjacent segment degeneration. The aim of this study was to investigate clinical efficacy of the DIAM system in treatment of degenerative lumbar disease in China.
Eight cases of lumbar vertebral instability were treated with the DIAM system at Peking Union Medical College Hospital from June 2006 to January 2008. There were 6 female and 2 male subjects with a mean age of 46.9 years and a range of 40 - 52 years. Radiographs and scores on outcome measures included the visual analogue scale (VAS) for pain and the Oswestry disability index (ODI). These scores were recorded before surgery and after surgery at intervals of 3-month, 6-month, 1-year and the final follow-up visit.
The follow-up time ranged from 12 - 31 months, with an average of 20.6 months. There were significant differences between preoperative and postoperative scores at each follow-up evaluation (P < 0.05). However, there was no significant difference between each postoperative follow-up score (P > 0.05). There were significant differences between preoperative and postoperative L4-5 segment activity at each time interval (P < 0.05), but no obvious difference was found within each postoperative follow-up evaluation (P > 0.05). The ODI and VAS score improvements were directly correlated with segment activity (r > 0.7, P < 0.05).
The DIAM system appears to be a useful and effective treatment in the surgical management of degenerative lumbar disease in certain patients. However, long-term follow-up is needed to evaluate the clinical outcomes of the device.
动态棘突间辅助运动（DIAM）系统旨在通过非融合手术稳定退行性脊柱节段，保持节段运动并预防相邻节段退变。本研究旨在探讨 DIAM 系统在中国治疗退行性腰椎疾病的临床疗效。
2006 年 6 月至 2008 年 1 月，北京协和医学院医院采用 DIAM 系统治疗 8 例腰椎不稳定患者。6 例为女性，2 例为男性，平均年龄 46.9 岁，年龄范围为 40-52 岁。影像学和疗效评估评分包括疼痛视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）。这些评分在术前和术后 3 个月、6 个月、1 年和最终随访时记录。
随访时间为 12-31 个月，平均 20.6 个月。每次随访评估的术前和术后评分均有显著差异（P<0.05）。然而，每次术后随访评分之间没有显著差异（P>0.05）。每个时间间隔的术前和术后 L4-5 节段活动均有显著差异（P<0.05），但术后每个随访评估均无明显差异（P>0.05）。ODI 和 VAS 评分的改善与节段活动直接相关（r>0.7，P<0.05）。
在某些患者中，DIAM 系统似乎是治疗退行性腰椎疾病的一种有用且有效的治疗方法。然而，需要进行长期随访以评估该设备的临床效果。
