| Background: Lumbar degenerative disease, is a sort of clinical syndroms such as disc-abnormalities, lumbar ligament laxity, facet hyperplasia, caused by lumbar degenerative. It is one of the major causes of low back pain, involving lumbar disc herniation, degenerative lumbar spinal stenosis, lumbar instability. Traditional spinal fusion was considered as the goldstandard for treating such deseases. With the development of internal fixation techniques, the fusion rate had reached 90%, but the corresponding improvement of the symptom did not be satisfied by the doctors nor the patients. Overall, the satisfaction was only 30%. So, a new concept of dynamic fixation, non-fusion fixation, which met the physiological need of the spine, had attached importance to Orthopedics. More and more dynamic stabilization systems had been used, and the treatment effects were found out be similar to the technology of fusion. The Wallis system was most used to cure lumbar degenerative diseases,.Although, there were controversies on it, and more probloms had existed, it still worths our deeper investigation to improve, for greater designs and effects.Aim: to review design principles, clinical application and treatment effects of each posterior dynamic stabilization systems, then analyse and compare the datas for the definite indications of the systems. Third, to figer out the problems and the development directions. Finally, by comprehensive theoretical support, I put emphasis on the efficacy of the Wallis system on treating lumbar degenerative disease.Methods: 1 to review the documents home and abroad these 10 years of the principles, clinical efficacies, development directions of each dynamic stabilization systems, then to compare it with the traditional spinal fusion. 2 A retrospective study of treatment for 18 patients suffered by lumbar degenerative diseases had carried out from Sep 2008 to Jul 2010, before and after implanting the Wallis systems. VAS test carried out before, 7 day after the operation, and the last follow-up to all cases. As well as, the height of endplates in two consecutive intervertebral discs before and after surgery were measured. ODI test was carried out before and after surgery. Statistical analysis came out after the datas.Result: 1 The efficacy of the non-fusion was similar with the fusion. But better vertebral activity can be saved. Non-fusion is more in line with the physical needs of the spine. 2 The follow-up lasted 7-22 months(meant 17 months). The VAS scores in before and 7-day after the surgery, the last follow-up was Statistically significant(p<0.05), there were Statistically differences in the ODI tests before and after the surgery. After all the heights of endplates in two consecutive intervertebral discs meant nothing in statistics.Conclusion: 1 The efficacy of the posterior dynamic stabilization system, which imitates natural spinal movements, is similar with the fusion skill. Controversy still exists, but the advantages leads a direction to the posterior spinal internal fixation, and a important point of stable treatment. Indications should be strictly controled in clinical applications. 2 Wallis system which can be easily implanted, is safe and effective for long-term, and the efficay is good for recent period. When losing effectiveness, the repair can be easily and safe carried out. In summary, it is one of the best treatments for the Lumbar degenerative disease. Also, it is a good transitional treatment in step therapy for treatment of lumbar degenerative diseases. |
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