Wang Qi, Liu Jun, Shi Ying, Chen Yu, Yu Hailong, Ma Junxiong, Ren Weijian, Yang Huifeng, Wang Hongwei, Xiang Liangbi
Department of Orthopedics, The General Hospital of Shenyang Military Commanding Area, No 83, Wenhua Road, 110840, Shenyang, China.
Eur Spine J. 2016 May;25(5):1409-1416. doi: 10.1007/s00586-015-4307-1. Epub 2015 Nov 17.
To determine the safety and short-term curative effects of internal fixation using a dynamic neutralization system (Dynesys) for multi-segmental lumbar disc herniation (ms-LDH) with the control group treated by posterior lumbar interbody fusion (PLIF).
Forty-five patients with ms-LDH were selected as study group treated with Dynesys and 40 patients as control group with PLIF. The surgical efficacy was evaluated by comparing the visual analogue scale (VAS) scores, the Oswestry Disability Index (ODI) scores and the ROMs of the adjacent segment before and after surgery. The postoperative complications related to the implants were identified.
All patients were followed up for an average duration of over 30 months. Dynesys stabilization resulted in significantly higher preservation of motion at the index level (p < 0.001), and significantly less (p < 0.05) hypermobility at the adjacent segments. VAS for back and leg pain and ODI improved significantly (p < 0.05) with both the methods, but there was no significant difference between the groups.
The non-fusion fixation system Dynesys is safe and effective regarding short-term curative effects for the treatment of ms-LDH.
采用动态中和系统(Dynesys)内固定治疗多节段腰椎间盘突出症(ms-LDH),以接受后路腰椎椎间融合术(PLIF)治疗的患者作为对照组,确定其安全性和短期疗效。
选取45例ms-LDH患者作为研究组,采用Dynesys治疗;40例患者作为对照组,采用PLIF治疗。通过比较手术前后的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分以及相邻节段的活动度来评估手术疗效。识别与植入物相关的术后并发症。
所有患者平均随访时间超过30个月。Dynesys固定术在病变节段的活动度保留方面显著更高(p < 0.001),相邻节段的活动过度显著更少(p < 0.05)。两种方法的腰背痛和腿痛VAS以及ODI均显著改善(p < 0.05),但两组之间无显著差异。
非融合固定系统Dynesys在治疗ms-LDH的短期疗效方面安全有效。