Analysis Of The Long-term Effect Of Wallis Interspinous Dynamic Stabilization System In The Treatment Of Lumbar Disc Herniation

BackgroundLumbar disc herniation is a common disease in Department of orthopedics.In recent years,with the rapid development of spine surgery,non fusion technology has been gradually applied to the treatment of degenerative lumbar spine surgery,the method of preserving motor function of spinal segments can avoid the stress change after spinal fusion of adjacent segment.Therefore,delaying the degenerative change of adjacent segment joint.Wallis system is one of the posterior non fusion technologies.It is one of the interspinous dynamic stabilization system which accords with the physiological characteristics of the spine.It has little damage to the lumbar physiological structure,retains the movement function of the segmental segment,and has little effect on the adjacent segments,and has a good clinical effect.ObjectiveTo investagate the long-term effect of Wallis interspinous dynamic stabilization system in the treatment of lumbar disc herniation.MethodsSeventy-nine patients with lumbar intervertebral disc herniation were treated in our hospital from July 2008 to July 2010 were included in our hospital.The clinical and imaging data were collected before and after 4 year and the last follow-up.Including: low back pain and leg pain visual analogue scale(VAS),the Japanese Association for Department of orthopedics treatment assessment score(JOA)and Oswestry Disability Index questionnaire score(ODI);X-ray analysis of operative and adjacent segments,lateral flexion extension of the Cobb angle and the flexion and extension of lumbar(ROM);disc height was detected by MRI,intervertebral disc degeneration was evaluated by Pfirrmann grade system.The long-term complications,such as intervertebral disc herniation and failure of internal fixation were analyzed.Results(1)Fifty-one patients were followed up effectively for a period of 6.3 to 9.3 years,with an average of 8.1 years.All patients with clinical symptoms and signs were alleviated.After 4 years follow-up,The VAS scores of low back and lower limb ? JOA score ? ODI scores were improved significantly(P<0.05);at the end of the follow-up,there are no significant difference between 4 years follow-up and end of follow-up in the VAS scores of low back and lower limb?JOA score and ODI score(P>0.05).(2)Compared with before operation,the Cobb angle of operative segment(hyperextension)was significantly decreased at 4 years and at the end of follow-up(P<0.05),while the Cobb angle of proximal segment(hyperextension)and proximal end segment(hyperextension)increased significantly(P<0.05).Compared with 4 years after the operation,the Cobb angle of the adjacent segment(hyperextension)of the head end and the adjacent segment(hyperextension)of the tail end increased significantly at the last follow-up(P<0.05).(3)Compared with the preoperative,4 years after operation and last follow-up surgery in patients with segmental ROM degree decreased significantly(P<0.05),the head end and the tail end of the adjacent segment of adjacent segment ROM increased significantly(P<0.05);compared with the preoperative,4 years after operation and last follow-up surgery the segmental intervertebral disc height was significantly increased(P<0.05).(4)One patients had recurrent disc herniation in 7 years after operation,and no longterm complications such as internal fixation loosening and displacement were found in the rest of the cases.ConclusionWallis interspinous dynamic stabilization system for lumbar disc herniation is in line with the concept of lumbar dynamic stability.It has potential protective effect on intervertebral disc,and has little effect on adjacent segment interference,and has good long-term effect.We believe that strict surgical indications and careful operation are important factors affecting the effect of the operation,especially the long-term effect.There are still few limitations in this study.For example,no control group was established.The effect of hydration and self repair of the intervertebral disc and the increase of adjacent segment activity on the adjacent segment degeneration need further exploration.