|
Objective Through the use of Dynesys fixation of lumbar degenerative disease in patients with follow-up study to assess the radiological findings and clinical efficacy, and explore the dynamics of the fixed system Dynesys lumbar degenerative disease indications, methods, and preliminary efficacy. Methods in August 2008 to December 2009 Application Dynesys system fixation 35 cases of lumbar degenerative disease, which followed more than three months of 24 patients. 24 patients, aged 35 to 80 years, mean 59 years. 9 males and 15 females. Fixed segment at L2-L3, 3 例; L4-L5, 12 例; L5-S1, 6 例; L3-L4-L5, 3 cases Shared pedicle screw 102, of which 4 patients combined Wallis interspinous distraction devices. The main indications for surgery degenerative diseases (including lumbar disc herniation, lumbar spinal stenosis and lumbar instability) caused by low back pain or low back pain patients. Among them, 10 cases of lumbar disc herniation; lumbar spinal stenosis 13 cases; lumbar spinal stenosis and degenerative lumbar 4 Ⅰ degree spondylolisthesis one case. All patients were first lumbar surgery. Preoperative evaluation included history, physical examination, X-ray, CT and MRI. All patients underwent lumbar segmental fenestration decompression and the same segment Dynesys fixation. Using ODI score, JOA score and VAS score standard preoperative and postoperative functional score was observed Dynesys lumbar degenerative disease curative effect. Results of intraoperative time required 155 to 290 minutes, the average 190 minutes. Intraoperative blood loss was 350 ~ 700ml, average 483ml. 11 patients, intraoperative blood transfusion 300ml ~ 650ml, average 417ml, five patients were treated with autologous blood transfusion. No postoperative spinal cord injury, no dural tear, no cerebrospinal fluid leakage, no wound infection. Followed up for 3 to 16 months, with an average 7.7 months. Preoperative ODI score was 27 to 64.8, with an average 49.2 points, to the last follow-up to improve to 1.8 to 28.8 with an average of 11.4 points; JOA score improved from 7 to 13 points, an average of 10.4 points, to improve the follow-up to last 13 to 29 with an average of 24.8 points; VAS score improved from 6 to 9 points, an average of 7.4 points, to the last follow-up to improve to 0-4 with an average of 2.1 points. NASS patient satisfaction index by evaluation of patient satisfaction with the treatment: Under the same conditions, the 20 patients clearly can accept the same operation, three patients could receive the same operation, one can not accept the same patient surgery. Conclusion Dynesys may be used alone lumbar degenerative disease, recurrent disc herniation, spinal mild instability, especially low back pain than leg pain obvious, is not suitable for treatment or rehabilitation of patients after conservative therapy can also be fused together with a mandatory fixed for the prevention of degeneration of the edge region. After an average of 7.7 months of clinical follow-up Display: Spinal decompression and fixation Dynesys system for lumbar degenerative diseases have a significant clinical effect. Clinical symptoms improved. Compared with the vertebral fusion, the operation without fusion, thus reducing the complications of harvesting bone area, reducing the interbody fusion implant procedure and so on.
|