目的探讨后路有限减压Dynesys动态固定治疗腰椎管狭窄症的早期临床效果。方法回顾性分析2012年3月至2014年3月中国人民解放军第86医院收治的采用后路有限减压联合Dynesys动态固定治疗的26例腰椎管狭窄症患者的临床资料,术前,术后7 d、6...目的探讨后路有限减压Dynesys动态固定治疗腰椎管狭窄症的早期临床效果。方法回顾性分析2012年3月至2014年3月中国人民解放军第86医院收治的采用后路有限减压联合Dynesys动态固定治疗的26例腰椎管狭窄症患者的临床资料,术前,术后7 d、6个月及末次随访时,应用视觉模拟量表（VAS）评分进行疼痛评估,采用Oswestry功能障碍指数（ODI）评价临床疗效,拍摄X线片测量手术节段椎间隙高度。结果手术时间90~150 min（平均105 min）、术中出血量100~350 m L（平均180 m L）;随访时间12~36个月（平均20个月）。术后7 d、6个月及末次随访时VAS评分、ODI均较术前明显改善（P〈0.05）,不同体位手术节段椎间隙高度与术前比较,差异均无统计学意义（P〉0.05）。未发现椎弓根钉松动、断裂,无钉绳系统、聚脂套管松动等并发症,未出现节段不稳或邻近节段退行性改变。结论后路有限椎管减压联合Dynesys系统动态固定治疗腰椎管狭窄症早期效果满意,能较好地维持手术节段椎间隙高度,预防椎间隙塌陷及腰椎不稳,但远期疗效尚需更长期的随访。展开更多
With the advance of spinal surgery in the last decade,surgical treatment of spinal tumors has been no longer limited to simple laminectomy.The principles of surgical treatment of spinal tumors include:(1) anterior app...With the advance of spinal surgery in the last decade,surgical treatment of spinal tumors has been no longer limited to simple laminectomy.The principles of surgical treatment of spinal tumors include:(1) anterior approach for the anterior lesion and posterior approach for the posterior lesion;(2) combined anterior and posterior approach for extensive lesions and(3) internal fixation for spinal stability.32 cases of spinal tumors were treated on the basis of the above guiding principles and 84%(27/32) showed excellent or good results.展开更多
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 ...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, 展开更多
文摘目的探讨后路有限减压Dynesys动态固定治疗腰椎管狭窄症的早期临床效果。方法回顾性分析2012年3月至2014年3月中国人民解放军第86医院收治的采用后路有限减压联合Dynesys动态固定治疗的26例腰椎管狭窄症患者的临床资料,术前,术后7 d、6个月及末次随访时,应用视觉模拟量表（VAS）评分进行疼痛评估,采用Oswestry功能障碍指数（ODI）评价临床疗效,拍摄X线片测量手术节段椎间隙高度。结果手术时间90~150 min（平均105 min）、术中出血量100~350 m L（平均180 m L）;随访时间12~36个月（平均20个月）。术后7 d、6个月及末次随访时VAS评分、ODI均较术前明显改善（P〈0.05）,不同体位手术节段椎间隙高度与术前比较,差异均无统计学意义（P〉0.05）。未发现椎弓根钉松动、断裂,无钉绳系统、聚脂套管松动等并发症,未出现节段不稳或邻近节段退行性改变。结论后路有限椎管减压联合Dynesys系统动态固定治疗腰椎管狭窄症早期效果满意,能较好地维持手术节段椎间隙高度,预防椎间隙塌陷及腰椎不稳,但远期疗效尚需更长期的随访。
文摘With the advance of spinal surgery in the last decade,surgical treatment of spinal tumors has been no longer limited to simple laminectomy.The principles of surgical treatment of spinal tumors include:(1) anterior approach for the anterior lesion and posterior approach for the posterior lesion;(2) combined anterior and posterior approach for extensive lesions and(3) internal fixation for spinal stability.32 cases of spinal tumors were treated on the basis of the above guiding principles and 84%(27/32) showed excellent or good results.
文摘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,
