在腰椎退行性磁盘疾病的动态稳定后,指数级融合和相邻细分病:说明案例
Kathleen R Ran1, Tej D Azad1, Bhavya Pahwa2
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Journal of neurosurgery. Case lessons
|July 15, 2024
概括
尽管声称维护运动,但Dynesys的动态稳定 (DDS) 可能会导致意外的融合和相邻部分疾病 (ASD). 仔细考虑这些风险对于管理退行性腰椎疾病至关重要.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 脊柱外科手术 脊柱外科手术
背景情况:
- Dynesys动态稳定 (DDS) 是作为退行性腰椎脊椎病的脊柱融合的替代方案.
- 与刚性融合相比,DDS的营销目的是保持脊柱运动,降低相邻细分病 (ASD) 的风险.
- 本案例报告检查了与DDS植入相关的潜在并发症.
研究的目的:
- 在Dynesys动态稳定 (DDS) 手术后报告意外融合和相邻部分疾病 (ASD) 的情况.
- 讨论这些并发症对退行性腰椎病的手术决策的影响.
主要方法:
- 一名60岁的女性,有L5-S1 DDS植入史,出现了反复出现的背部和腿部疼痛.
- 图像检测显示了无意的L5-S1融合和L4-L5相邻段疾病 (ASD) 与狭窄.
- 患者接受了修复手术,包括去除DDS,减压和L4-L5融合.
主要成果:
- 患者经历了症状的进展,尽管最初的DDS植入.
- 在指数水平 (L5-S1) 和在L4-L5的相邻段疾病 (ASD) 中确定了无意的融合.
- 为了解决并发症,进行了修复手术.
结论:
- Dynesys的动态稳定 (DDS) 可以导致意外的融合和相邻部分疾病 (ASD).
- 这些并发症挑战了DDS作为纯粹运动保存技术的概念.
- 当考虑DDS对于退行性腰部疾病时,患者选择和长期监测至关重要.
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