ABSTRACT
Objective To summarize the clinical effect of transpedicular Dynesys dynamic fixation for treating degenerative lum-bar disease.Methods 34 cases of degenerative lumbar disease were treated by transpedicular Dynesys dynamic fixation and per-formed the retrospective analysis.The VAS score of lumbago was (6.01±0.98),the VAS score of skelalgia was (5.47±0.63), ODI was(64.47 ±2.06)%.The cranial intervertebral space height in the fixed segment was(12.01±1.08)mm,the intervertebral space height in the fixed segment was(11.47±1.13)mm;the caudal intervertebral space height in the fixed segment was(11.95± 1.06)mm;the intervertebral motion range of the cranial segment in the fixed segment was(8.11±1.21)°,the intervertebral motion range of the fixed segment was(8.47±1.63)°,the intervertebral motion range of the caudal segment in the fixed segment(7.86± 1.36)°.39 intervertebral spaces in 27 cases adopted the decompression combined with Dynesys fixation,the single intervertebral space in 7 cases was performed with Dynesys fixation alone.Results All patients smoothly pulled through the perioperative period. No complications of wound infection,leakage of cerebralspinal fluid and nerve inj ury occurred,wound infection,leakage of cerebro-spinal fluid and nerve injury.All patients were followed up for 25-45 months,averaged 31.2 months.The VAS score of lumbago at the last time of follow up was (1.85±1.03),the VAS score of skelalgia was(1.54±0.18),ODI was(11.42±1.51)%,the cranial intervertebral space height in the fixed segment was(11.85±0.93)mm,the intervertebral space height of the fixed segment was (11.34±1.02)mm,the caudal intervertebral space height in the fixed segment was(11.62±0.97)mm;the intervertebral space motion range of the cranial segment in the fixed segment was(8.85 ± 1.33)°,the intervertebral space motion range of thye fixed segment was(4.54±1.78)°,the intervertebral space motion range of the caudal segment in the fixed segment was(7.62±1.21)°. Conclusion Transpedicular Dynesys dynamic fixation for treating degenerative lumbar disease can confine and reserve the motion range of the fixed segment,lessen lumbago and skelalgia,improve the function of waist and leg and have no obvious influence on the adjacent segment,its short-term therapeutic effect is satisfactory,but long-term therapeutic effect needs the clinical observation of long time and large amount cases.
ABSTRACT
Objective To study correlation between MRI signal intensity of the lumbar intervertebral disc and collagen content in the nucleus pulposus.Methods Thirty-one cases with lumbar intervertebral disc herniation(male 21,female 10)received percutaneous lumbar disketetomy.Thirty-one specimens of nucleous pulposus were obtained from percutaneous lumbar disketctomy procedure and collagen content in them was measured with reformed hydroxyproline measurement method.The signal intensity(SI) of lumbar intervertebral disc and cerebrospinal fluid was measured in T_2 WI sagittal image and then ratio of disc SI to cerebrospinal fluid SI was calculated.The Pearson analysis was used to analyze the correlation between the collagen content and SI ratio and disc SI on T_2 WI.Results Collagen content and SI ratio were (231.0?63.5)mg/g and 0.19?0.07,respectively.There was negative correlation between them (r=-0.61,P