RESUMEN
BACKGROUND:The patients undergoing lumbar discectomy have a higher risk of recurrence. There are many different ways of reoperation, but there are few studies on spine-pelvis sagittal morphology of patients with recurrent lumbar disc herniation. OBJECTIVE:To compare the effect of discectomy and posterior lumbar interbody fusion on spine-pelvis sagittal morphology of patients with recurrent lumbar disc herniation. METHODS:Sixty-one patients of recurrent lumbar disc herniation after discectomy were divided into discectomy group (n=30) and posterior lumbar interbody fusion group (n=31) according to the re-repair method. The height of intervertebral disc, lumbar lordosis and pelvic projection angle in the two groups before and after treatment were measured and compared based on standing spine lateral X-ray images. RESULTS AND CONCLUSION: After treatment, the height of intervertebral disc, lumbar lordosis and pelvic projection angle of patients in discectomy group were not significantly changed compared with before treatment (P> 0.05). After treatment, the height of intervertebral disc, lumbar lordosis and pelvic projection angle of patients in posterior lumbar interbody fusion group were significantly increased compared with those before treatment (P 0.05).After treatment, the height of intervertebral disc, lumbar lordosis and pelvic pelvic projection angle were significantly increased in the posterior lumbar interbody fusion group compared with the discectomy group (P < 0.05). These results demonstrate that discectomy cannot significantly change the spine-pelvis sagittal morphology of patients subjected to re-operation, but compared with the discectomy treatment, posterior lumbar interbody fusion has a greater impact on spine-pelvis sagittal morphology of patients subjected to re-operation.
RESUMEN
BACKGROUND:Studies have shown that morphological characteristics of iliolumbar ligament are controversial. Few Chinese studies concerned anatomical structure and biomechanical features of Chinese iliolumbar ligament, and no detail statistical data were found. OBJECTIVE: To study the relationship of L5/S1 disc herniation and the L5 spondylolisthesis with iliolumbar ligament. METHODS: A total of 28 cases receiving health examination, 26 patients with L5/S1 disc herniation and 26 patients with L5 spondylolisthesis were recruited from First Affiliated Hospital of Soochow University in China in 2013. Normal group contained 9 males and 19 females. L5/S1 disc herniation group contained 14 males and 12 females. L5 spondylolisthesis group contained 7 males and 19 females. Of them, there were 13 cases of spondylolysis and 13 cases degenerative spondylolisthesis; as wel as 24 cases with degree I spondylolisthesis and 2 cases of degree II spondylolisthesis. The relative widths of the L5 transverse process (RT value) on the X-ray of the lumbar vertebra of each case were measured and calculated. RESULTS AND CONCLUSION: No significant difference in age and gender was detected in the normal group, L5/S1 disc herniation group and L5 spondylolisthesis group. RT value was higher in the normal group than in the L5/S1 disc herniation and L5 spondylolisthesis groups (alP=0.000). RT value was greater in the L5/S1 disc herniation group than in the L5 spondylolisthesis group (P=0.000). No significant difference in RT value was detectable between males and females. No significant difference in RT values was visible between the left and right sides. In patients with L5 spondylolisthesis, RT values were lower in the degenerative spondylolisthesis patients than in spondylolysis patients (P=0.004). Results indicated that the strength of iliolumbar ligament in normal person was higher than that with L5/S1 disc herniation and L5 spondylolisthesis. The strength of iliolumbar ligament in L5/S1 disc herniation patients was higher than that with L5 spondylolisthesis patients. The strength of iliolumbar ligament in spondylolysis patients was higher than that with L5 degenerative spondylolisthesis patients. The mechanical strength of iliolumbar ligament was possibly associated with L5/S1 disc herniation and L5 spondylolisthesis.