Posterior lumbar interbody fusion plus screw implantation with posterior ligamentous complexes under microscope for lumbar degenerative disease / 中国组织工程研究

ABSTRACT

BACKGROUND:Removing the posterior ligamentous complexes during posterior lumbar interbody fusion (PLIF) may influence motion and load bearing characteristics of the adjacent segments,contributing to the postoperative instability at the adjacent segment,which is one of the important factors for adjacent segment degeneration.OBJECTIVE:To evaluate the clinical effectiveness of the PLIF plus screw implantation preserving posterior ligamentous complexes under microscope.METHODS:Thirty-six patients with single-level lumbar degenerative disease were enrolled,which were allotted to experimental (n=17) and control (n=1 9) groups,followed by treated with PLIF plus screw implantation preserving posterior ligamentous complexes,and traditional PLIF plus screw implnatation,respectively.The Visual Analogue Scale scores and Oswestry Dysfunction Index at baseline and postoperative 3 months were assessed.The adjacent segment degeneration was observed through radiology during follow-up.RESULTS AND CONCLUSION:The Visual Analogue Scale and Oswestry Dysfunction Index scores in the two groups were significantly lower than those before treatment (P ＜ 0.01),and the postoperative scores in the experimental group were significantly lower than those in the control group (P ＜ 0.01).The adjacent segment degeneration occurred in two cases in the experimental group and 8 cases in the control group during follow-up.Radiology revealed that the internal fixative was stable,none of screw loosening,rupture or pullout.These results suggest that PLIF plus screw implantation with posterior ligamentous complexes can effectively relieve the pain and dysfunction in the lumbar degenerative patients,and reduce the incidence of adjacent segment degeneration.