Short-term effectiveness of single-level lsobar TTL dynamic internal fixation in the treatment of lumbar degenerative diseases / 中国组织工程研究

ABSTRACT

BACKGROUND: The short-term effects of dynamic internal fixation and whether dynamic internal fixation system can prevent or delay the process of adjacent level degeneration after lumbar surgery remain in controversy.OBJECTIVE: To investigate the short-term clinical effectiveness of single-level Isobar TTL dynamic internal fixation in the treatment of degenerative lumbar diseases. METHODS: Data of 20 patients who suffered from lumbar degenerative diseases and underwent posterior decompression combined with single-level Isobar TTL dynamic internal fixation, including 11 male patients and 9 female patients, were retrospectively analyzed; the average age of these patients was 47.4 (35-62) years old. Visual analog scale, Japanese Orthopaedic Association scores and Oswestry disability index were used to assess clinical outcomes. Disc height, range of motion, and University of California at Los Angeles Grading Scale were measured on X-ray films to evaluate the status of disc degeneration on both dynamic fixed segment (index segment) and superior adjacent segment. RESULTS AND CONCLUSION: All follow-up patients successfully completed the operation. The average follow-up time was 14.4 (12-27) months. No blood vessels, nerve injury, loose internal fixation or rupture occurred. At the last follow-up, Visual Analog Scale, Japanese Orthopaedic Association scores and Oswestry Disability Index were significantly improved (P < 0.05); range of motion of dynamic fixation segment reduced (P < 0.05) as compared with that before surgery. Intervertebral height of dynamic fixation segments and University of California at Los Angeles Grading Scale classification were not significantly different between follow-up and before surgery (P > 0.05). Intervertebral height of superior adjacent segment, intervertebral range of motion and University of California at Los Angeles Grading Scale classification were not significantly different (P > 0.05). These results indicate that single-level Isobar TTL dynamic internal fixation proved to have satisfactory clinical outcomes in the treatment of lumbar degenerative diseases. During follow-up, disc degeneration on either index segment or superior adjacent segment is not accelerated.