Wang Kaifeng, Zhu Zhenqi, Wang Bo, Zhu Yi, Liu Haiying
Department of Spinal Surgery, Peking University People's Hospital, 11 Xizhimen South Street, West District, Beijing, China.
BMC Musculoskelet Disord. 2015 May 14;16:117. doi: 10.1186/s12891-015-0561-y.
Dynamic interspinous stabilization devices generally provide satisfactory results, but can result in recurrent lumbar disc herniation, spinous process fracture, or bone resorption of the spinous process. The purpose of this study was to investigate if the Wallis dynamic stabilization device is associated with bone resorption.
Patients who underwent single-segment posterior lumbar decompression and implantation of a Wallis dynamic interspinous stabilization device at the L4/5 level between January 1, 2009 and October 1, 2011 were included. Bone resorption rate, Oswestry Disability Index (ODI), Japanese Orthopedic Association (JOA) score, and visual analogue scale (VAS) pain score were measured. Patient baseline and 1-year follow-up data were collected and analyzed. The bone resorption rate of the L4 and L5 spinous processes was calculated.
Twenty four males and 20 females with a mean age of 42.7 ± 14.7 years were included. Twenty nine patients had significant bone resorption (bone resorption rate > 20%) and 15 had no bone resorption (bone resorption rate ≤ 20%) at 1 year after surgery. Lumbar lordosis ≥ 50° was associated with a lower bone resorption than lumbar lordosis < 50° and increasing BMI was associated with increased bone resorption. There were no significant differences between the bone resorption and no bone resorption groups in the improvement rate of VAS pain score, ODI, and JOA score at 1 year after surgery.
Significant bone resorption occurs within 1 year after implantation of the Wallis device in more than 50% of patients. However, it does not affect short-term functional results.
动态棘突间稳定装置通常能提供令人满意的效果，但可能导致复发性腰椎间盘突出症、棘突骨折或棘突骨吸收。本研究的目的是调查Wallis动态稳定装置是否与骨吸收有关。
纳入2009年1月1日至2011年10月1日期间在L4/5节段接受单节段后路腰椎减压并植入Wallis动态棘突间稳定装置的患者。测量骨吸收率、Oswestry功能障碍指数（ODI）、日本矫形外科学会（JOA）评分和视觉模拟量表（VAS）疼痛评分。收集并分析患者的基线数据和1年随访数据。计算L4和L5棘突的骨吸收率。
纳入24例男性和20例女性，平均年龄42.7±14.7岁。术后1年，29例患者出现明显骨吸收（骨吸收率>20%），15例无骨吸收（骨吸收率≤20%）。腰椎前凸≥50°的患者骨吸收低于腰椎前凸<50°的患者，体重指数增加与骨吸收增加相关。骨吸收组和无骨吸收组术后1年VAS疼痛评分、ODI和JOA评分的改善率无显著差异。
超过50%的患者在植入Wallis装置后1年内出现明显骨吸收。然而，这并不影响短期功能结果。
