Clinical Efficacy And Imaging Analysis Of The Treatment Of Lumbar Degenerative Diseases With The Second Generation Of Wallis Dynamic Stabilization System

Background:Lumbar disc herniation(LDH),lumbar spinal stenosis(LSSS)and other lumbar degenerative diseases(LDD)are a common and frequently-occurring disease of orthopedics.The incidence of such diseases increases with the aging process of society,showing an increasing trend year by year.At present,in the surgical treatment of this type of disease,simple nucleus pulposus removal surgery has the disadvantages of loss of intervertebral height and intervertebral foramen height,affecting the stability of the spine.There is loss of mobility of the surgical segment after intervertebral fusion and internal fixation.Segmental degeneration and other problems,lumbar disc replacement is currently less mature due to the immature technology,the effect is not clear,the second generation of interspinous Wallis dynamic stability system for the treatment of lumbar degenerative diseases has emerged,this technology The core of the concept is to provide dynamic fixation of the diseased segment on the basis of adequate decompression nerves,to preserve the normal lumbar vertebral physiology,to reduce the damage and less trauma,and to maintain the stability of the spine to maximize the preservation of the surgical segment.The degree of activity reduces the loss of activity of the segment due to local segment fusion and the abnormal concentration of stress in the upper and lower adjacent segments,thereby effecttively alleviating and reducing the degeneration of the upper and lower adjacent segments after surgery,and has good clinical efficacy.Purpose:This study is to investigate the clinical efficacy and imaging analysis of the application of the second generation of Wallis dynamic stabilization system in the treatment of lumbar degenerative diseases.Methods:Make a retrospective analysis of patients who underwent surgical treatment of the lumbar degenerative disease with the second generation of Wallis dynamic stabilization system in the spine surgery since October 2016 to December 2017.A total of 46 patients met the inclusion criteria,including 27 males and 19 females;aged 28 to 83 years,mean58.15 ± 12.99 years old;follow-up period of at least 12 months.Clinical data and imaging data were collected before surgery,7 days after surgery,3 months after surgery,6 months after surgery,and 1 year after surgery.The clinical efficacy and neurological improvement were evaluated by VAS score,JOA score and ODI score.The intervertebral flexion and extension(ROM),intervertebral disc height and intervertebral foramen height were observed by lumbar spine positive lateral and overextended flexion radiographs.The improvement of the intervertebral disc was observed by lumbar MRI.Result:All patients were followed up for a period of 12 months or more(12 to 22 months)with an average of 16.20 months.The operation of the second generation of Wallis dynamic stabilization system between the interspinous processes was compared with that before surgery:(1)The degree of ROM in the surgical segment was lower than that before surgery,and the difference was statistically significant(P<0.05).(2)the surgical segment(over)The Cobb angle was decreased compared with that before surgery(P<0.05).(3)The height of the intervertebral disc in the surgical segment was increased compared with that before operation(P<0.05).(4)The height of the intervertebral foramen of the surgical segment increased compared with that before surgery(P<0.05).(5)The VAS score and ODI score were lower than 1 month after surgery and 6 months after surgery,JOA The score was higher than that before surgery,and the difference was statistically significant(P<0.05).There was no significant difference between the other follow-up points and the preoperative data,which was not statistically significant.Among the 46 patients who were followed up,1 patient developed intraspinal hematoma compression on the 4th and 7th day after surgery,the incidence rate was 2.17%.The remaining patients showed no obvious complications.Conclusion:Through the statistical analysis of pre-operative and post-operative data,the clinical effect of using the second generation of Wallis dynamic stabilization system in the treatment of lumbar degenerative diseases is reliable,and the patient satisfaction is high,which is consistent with the concept of “dynamic fixation” of the lumbar spine.The significant advantage of this procedure is that it maximizes spinal mobility and reduces the degeneration of adjacent segments,while potentially protecting the intervertebral disc.Collected patient imaging data showed that all patients could retain the degree of motion and lumbar motion in some cases after surgery,and restore the intervertebral height and intervertebral foramen height of the surgical segment to a certain extent.The clinical effect was good in the short and medium term.