Midterm clinical effects of decompression and Dynesys dynamic stabilization in treating multi-segmental lumbar spinal stenosis
10.3969/j.issn.1004-406X.2024.07.01
- VernacularTitle:椎管减压Dynesys动态固定治疗多节段腰椎管狭窄症的中期临床疗效
- Author:
Lei LUO
1
;
Liehua LIU
;
Chen ZHAO
Author Information
1. 重庆医科大学附属第三医院脊柱外科 401120重庆市
- Keywords:
Lumbar spinal stenosis;
Multiple segments;
Dynamic stabilization;
Efficacy;
Complications
- From:
Chinese Journal of Spine and Spinal Cord
2024;34(7):673-678
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To assess the midterm clinical outcomes after decompression and dynamic stabiliza-tion(Dynesys system)in multi-segmental lumbar spinal stenosis.Methods:The clinical data of 59 patients with lumbar spinal stenosis treatedwith decompression and 3 or more segments dynamic stabilization in our hospital from March 2010 to June 2015 were retrospectively reviewed.There were 28 males and 31 females,with an average age of 67.6±8.9 years(49-80 years).The operative time,blood loss and complications of the patients were collected.Before operation,at 3 months after surgery and final follow-up,visual analog scale(VAS)was used to assess the pain status of low back and leg,and Oswestry disability index(ODD was adopt-ed for functional evaluation,and also lumbar lordosis,range of motions(ROMs)of fixed segments and the first upper adjacent segment were evaluated with X-ray examination in the mean time,and the retention of ROM of the fixed segments was also calculated.Results:3 segmental Dynesys dynamic stabilizations were per-formed in 44 patients,4 segmental dynamic stabilizations were in 13 paticnts,5 segmental stabilizations were in 2 patients.The operative time was 259±58min,and the average blood loss was 593±296mL.The mean follow-up period was 7.2±1.3 years(range 5-9 years).The VAS scores and ODI at 3 months after operation improved significantly compared with those preoperatively(P＜0.05).At final follow-up,loosening was observed in 6 screws in 4 patients,who were asymptomatic;Wound infection developed in 1 patient at 34 months after surgery,which was cured by puncture pumping pus,irrigation and antibiotics for 4 weeks;None of the patients underwent revision surgery.At final follow-up,the ROM of the fixed segments was 13.1°±4.7°,which on average retained 43.8％of the preoperative ROM(28.9°±8.1°),and the ROM of the adjacent upper segement,and lumbar lordosis were preserved compared with before operation with no statistical difference(P＞0.05).Conclusions:Decompression and dynamic stabilization with Dynesys system was a safe and effective treatment in patients with multi-segmental lumbar spinal stenosis,which preserves lumbar activities with minor injury.
