中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (43): 8109-8112.doi: 10.3969/j.issn.1673-8225.2010.43.032

• 骨与关节综述 bone and joint review • 上一篇    下一篇

动态非融合椎弓根螺钉软系统治疗腰椎退变和不稳

周子红1，程  立1，殷渠东2   

  1. 1 无锡市人民医院骨科，江苏省无锡市 214000；  2无锡骨科医院，江苏省无锡市214000　
  • 出版日期:2010-10-22 发布日期:2010-10-22
  • 作者简介:周子红★，男，1970年生，江苏省无锡市人，汉族，1990年徐州医学院毕业，硕士，主治医师，主要从事脊柱外科基础和临床研究 yinqudong@sina.com

Dynesys for lumbar degeneration and instability

Zhou Zi-hong1, Cheng Li1, Yin Qu-dong2   

  1. 1 Department of Orthopaedics, Wuxi People’s Hospital, Wuxi  214000, Jiangsu Province, China; 2 Department of Orthopaedics, Wuxi Orthopaedic  Hospital, Wuxi  214000, Jiangsu Province, China
  • Online:2010-10-22 Published:2010-10-22
  • About author:Zhou Zi-hong★, Master, Attending physician, Department of Orthopaedics, Wuxi People’s Hospital, Wuxi 214000, Jiangsu Province, China yinqudong@sina.com

PDF

598

被引次数

15

摘要：

背景：强直固定脊柱融合是治疗腰椎退变和不稳的传统手术方法，但是，临床满意率还不够高，而且还存在潜在并发症。Dynesys是一种新的治疗腰椎退变和不稳的非融合、动态椎弓根螺钉软系统固定，可保留椎间盘和关节突关节功能的完整性，维持节段间正常运动，而且对临近节段无不利影响。
目的：总结分析Dynesys有关研究，介绍Dynesys的主要治疗机制、生物力学性能、治疗效果和适应证、禁忌证。
方法：检索1990/2010 PubMed数据库、中国知网数据库、维普数据库有关Dynesys方面的文献，英文检索词为“ Lumbar, Non fusion，Dynesys”，中文检索词为“腰椎，非融合，Dynesys”。排除重复性研究，计算机初检得到49篇文献，根据纳入标准保留31篇进一步归纳总结。
结果与结论：Dynesys是一种治疗腰椎退变和不稳的非融合、动态椎弓根螺钉软系统固定。它在维持腰椎一定活动度和局部前凸条件下，不仅能够限制不稳定节段异常运动，还能减少椎间盘和小关节的负荷，从而达到治疗目的。临床结果显示，疗效与传统强制固定融合术相当，但它的手术创伤较小，临近节段无继发退变等风险增加，更符合脊柱生理性稳定，即使失败后还可以行强制固定融合术。这种非融合脊柱后路内固定，避免了部分患者脊柱融合，最大限度地保留了脊柱功能,符合当今脊柱非融合功能重建发展趋势。

关键词: 腰椎, 非融合, Dynesys, 椎弓根螺钉, 腰椎退变, 腰椎不稳

Abstract:

BACKGROUND: Spine fusion with rigid fixation is a traditional surgical method for treatment of lumbar degeneration and instability, but the clinical satisfaction rate is low, and there are potential complications. Dynesys is a new non-fusion, dynamic pedicle screw fixation system for the treatment of lumbar degeneration and instability. The system can retain spine function of intervertebral disc and facet joint integrity, maintain the normal movement between segments, as well as have no adverse effects on adjacent segments.
OBJECTIVE: To summarize and analyze Dynesys related studies, introduce its major therapeutic mechanism, biomechanics, treatment results, and indications, and contraindications.
METHODS: A computer-based online search of PubMed database (http://www.ncbi.nlm.nih.gov/sites/entrez); China HowNet Database (http://ckrd.cnki.net/grid20), VIP Database (http://www.cqvip.com/) was performed for related articles published between 1990 and 2010 with key words “Lumbar, Non fusion, Dynesys" in English and Chinese. Repeated researches were excluded. A total of 49 articles were collected and 31 were included.
RESULTS AND CONCLUSION: Dynesys is a nonfusion, dynamic or soft tissue pedicle screw stabilization system for treatment of degeneration and instability of lumbar spine. This new system is based on lumbar stability and preservation of intersegmental kinematics and alleviation of loading at the disc and the facet joints. The treatment results were similar to conventional fusion procedures; in addition, Dynesys is less invasive and eliminates the potential risk of adjacent level degeneration as well as restores the physiological stability of spine. Even if failed, traditional fusion procedure is considered. This nonfusion posterior spinal fixation prevents spinal fusion for some patients, maximizes retention of the spine functions, and is consistent with trend of current functional reconstruction of spinal nonfusion.

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