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Long-Term Outcome of dynesys dynamic stabilization for Lumbar Spinal Stenosis

Chinese Medical Journal 2018年第21期131卷 2537-2543页

作者： Yang Zhang Zhi-Cheng Zhang Fang Li Tian-Sheng Sun Jian-Lin Shan Kai Guan Guang-Min Zhao Li-Zhi Zhang Medical School of Chinese People's Liberation Army Beijing 100853 China Department of Orthopedics Army General Hospital of Chinese People's Liberation Army Beijing 100700 China

Background： Many clinical studies over the past decade have indicated positive outcomes for patients treated with dynesys dynamic stabilization for lumbar degenerative disease. However, long-term outcomes of dynesys for lumbar spinal stenosis are rarely reported. The aim of this study was to analyze the long-term clinical and radiologic outcomes for patients with lumbar spinal stenosis treated with dynesys stabilization. Methods： Thirty-eight patients with lumbar spinal stenosis were treated with dynesys stabilization from July 2008 to March 2010. The minimal duration of follow-up was 72 months. The patients were divided into stenosis and spondylolisthesis groups according to degenerative spondylolisthesis. Clinical outcomes were evaluated using the Oswestry Disability Index （ODI） and visual analog scale （VAS）. Radiographic evaluations included range of motion （ROM） and the disc heights of stabilized segments and the upper adjacent segments. We also evaluated the occurrence of radiographic and symptomatic adjacent segment degeneration （ASD）. Results： There were 23 patients in stenosis group and 15 patients in spondylolisthesis group. The ODl scores were significantly improved at the final follow-up evaluation, as compared to the baseline values （ 16.1± 5.7 vs. 57.2 ± 14.2, t = 61.4 l, P 〈 0.01 ）. The VA S scores for back and leg pain were significantly improved from 4.82 ±0.89 and 4.04 ± 0.82 preoperatively to 0.93± 0.61 and 0.54 ± 0.51 postoperatively （t = 6.59, P 〈 0.01, and t = 5.91, P 〈 0.01, respectively）. There were no differences between the two groups with respect to VAS and ODI scores. The ROM of stabilized segments decreased significantly from 7.8°± 2.4° to 4.5° ± 1.5° （t = 7.18, P 〈 0.05）, while the upper adjacent segments increased significantly from 8.3° ± 2.4° to 10.4° ± 2.4° （t = 2.87, P = 0.01）. The change in disc height of stabilized segments was not significant （11.9 ±2.1 preoperatively vs. 12.5 ± 1.5 postoperatively, t = 1.43, P = 0.15）, whereas t

关键词： Adjacent Segment Degeneration dynamic stabilization: dynesys Lumbar Spinal Stenosis Lumbar Spondylolisthesis

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