scholarly journals Longitudinal Spinous‐Splitting Laminoplasty with Coral Bone for the Treatment of Cervical Adjacent Segment Degenerative Disease: A 5‐Year Follow‐up Study

2021 ◽  
Author(s):  
Wei He ◽  
Da He ◽  
Qi‐long Wang ◽  
Wei Tian ◽  
Bo Liu ◽  
...  
Keyword(s):  
Degenerative Disease ◽  
Adjacent Segment ◽  
Follow Up Study

Preliminary Experience with a Novel System of Facet Fixation to Treat Patients with Lumbar Degenerative Disease. A New Perspective in Minimally Invasive Spine Surgery?

2017 ◽  
Vol 79 (04) ◽  
pp. 296-301 ◽  
Author(s):  
Natale Francaviglia ◽  
Gabriele Costantino ◽  
Alessandro Villa ◽  
Domenico Iacopino ◽  
Maria Pappalardo ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Degenerative Spondylolisthesis ◽  
Degenerative Disease ◽  
Posterior Fixation ◽  
Adjacent Segment ◽  
Foraminal Stenosis ◽  
Lumbar Degenerative Disease ◽  
Black Disk ◽  
Clinical Series

Purpose We report our experience with a novel surgical device for the treatment of lumbar degenerative microinstability. Facet Wedge (DePuy Synthes, Raynham, Massachusetts, United States) is a novel technique of intra-articular lumbar facet fixation that provides a minimally invasive alternative to standard posterior fixation. Materials and Methods From November 2014 to July 2015, 38 patients underwent single-level Facet Wedge implantation. The main surgical indications included herniated disk (18 patients), spinal canal and foraminal stenosis (14 patients), and Meyerding grade I degenerative spondylolisthesis (6 patients). All the patients showed radiologic signs of microinstability: hyperintensity in both facet joints (facet fluid signal) in T2-weighted magnetic resonance imaging and a black disk as a sign of degenerative disease. No slippage was evident at dynamic radiograph. After a period of conservative treatment (minimum of 6 months), surgery was performed. All patients' follow-up lasted over at least 12 months. Results The low back visual analog scale score decreased significantly after surgery (from an average of 8.2 to 3.1 at final follow-up). Postoperatively, the Oswestry Disability Index showed a significant reduction (14.7 on average). No slippage or signs of adjacent segment degeneration was detected in neuroimaging follow-up. Conclusion Facet Wedge allows facet fixation in lumbar degenerative microinstability. To the best of our knowledge, this is the first clinical series reported in the literature on this novel device.

scholarly journals Analysis of the influence parameters spine-pelvic balance on the risk of development degeneration and degenerative disease of adjacent segments after lumbar spine rigid fixation

2021 ◽  
pp. 24-30
Author(s):  
A. V. Spiridonov ◽  
Yu. Ya. Pestryakov ◽  
A. A. Kalinin ◽  
V. A. Byvaltsev
Keyword(s):  
Lumbar Spine ◽  
Lumbar Lordosis ◽  
Degenerative Disease ◽  
Adjacent Segment ◽  
Rigid Fixation ◽  
Inclusion Criteria ◽  
Biomechanical Stress ◽  
Lumbar Stabilization ◽  
Adjacent Segments

Introduction An increase in the load on adjacent segments causes changes in the parameters of the spinal-pelvic balance and, as a consequence, the development of the so-called biomechanical «stress». Such pressures are a key link in the pathogenesis of degeneration, and in the presence of clinical and neurological manifestations of the latter and adjacent segment degenerative disease (ASD/ASDd).Objective of this study was to assess the effect of the parameters of the spinal pelvic balance on the risk of developing ASD/ASDd after dorsal decompression-stabilizing interventions (DDSI).Material and Methods The study included medical records of patients who underwent DDSI for lumbar spine degenerative diseases. Clinical and instrumental parameters were assessed.Results Based on the inclusion criteria, 98 patients (48 with signs of ASD/ASDd and 50 without) were included in the study. The average postoperative follow-up period for the respondents was 46.6 ± 9.8 months. If PI/ LL parameters were <10 and the ratio of segmental and global lumbar lordosis (LIV-SI/LI-SI) was 50% or more, the incidence of ASD/ASDd was significantly lower in patients who underwent rigid lumbar stabilization surgery.Conclusion The values of PI/LL parameters and the ratio of segmental and global lumbar lordosis are obvious risk factors for the development of ASD/ASDd after rigid lumbar spine DDSI.

scholarly journals Clinical effect analysis and radiographic outcomes of Isobar TTL system for two-segmental lumbar degenerative disease: a retrospective study

2019 ◽  
Author(s):  
zhisheng ji ◽  
Zhi-Sheng Ji ◽  
Hua Yang ◽  
Yu-Hao Yang ◽  
Shao-Jin Li ◽  
...  
Keyword(s):  
Clinical Effect ◽  
Degenerative Disease ◽  
Adjacent Segment ◽  
Intervertebral Space ◽  
Lumbar Degenerative Disease ◽  
Effect Analysis ◽  
Radiographic Outcomes ◽  
Adjacent Segments ◽  
Rigid Group

Abstract Background: Non-fusion fixation is an effective way to treat lumbar degeneration. The present study evaluated the clinical effect analysis and radiographic outcomes of Isobar TTL system for two-segmental lumbar degenerative disease. Method: Forty-one patients with two-segmental lumbar degenerative disease who underwent surgical treatment by Isobar TTL dynamic stabilization system (n=20) and rigid system (n=21) from January 2013 to June 2017. The mean follow-up period was 23.6 (range 15–37) months. Clinical outcomes were evaluated by oswestry dysfunction index (ODI), visual analogue score (VAS) and modified Macnab. Radiographic evaluations included the height of intervertebral space and range of motion (ROM) of the operative segments and proximal adjacent segment. The intervertebral disc signal change was classified by the modified Pfirrmann grade and University of California at Los Angeles (UCLA) system. Results: The clinical outcomes including the ODI and VAS were significantly improved in two groups after operation, but the difference between two groups was not significant. In addition, the clinical efficacy of modified Macnab in two groups was similar too. Radiologic outcomes include height of intervertebral space, lumbar mobility and intervertebral disc signal. The height of intervertebral space of upper adjacent segments of L2/3 in the rigid group were significantly lower than those in the Isobar TTL group at the last follow-up. Furthermore, the number of fixed segment ROM of L3/4 in Isobar TTL group was significantly lower than pre-operation, suggesting that fixed segment ROMs in Isobar TTL group were limited. And, the ROM of upper adjacent segments of L2/3 in the last follow-up of rigid group increased significantly, while the ROM of L2/3 in Isobar TTL group haven’t changed after operation. At last, the incidence of adjacent segment degeneration was significantly greater in the rigid group than the Isobar TTL group according to modified Pfirrmann grading system and the UCLA system. Conclusion: Isobar TTL system could get a good clinical effect for treatment of two-segmental lumbar degenerative disease. Compared with rigid fixation, Isobar TTL system can get better radiographic outcomes and maintain the mobility of the stabilized segments with less influence on the proximal adjacent segment.

scholarly journals Longitudinal spinous-splitting laminoplasty with coral bone for the treatment of cervical adjacent segment degenerative disease: A 5-year follow-up study

2020 ◽  
Author(s):  
Wei He ◽  
Qilong Wang ◽  
Wei Tian ◽  
Bing Han ◽  
Yumei Wang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Neck Disability Index ◽  
Degenerative Disease ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Segment ◽  
Vas Score ◽  
Cervical Plate ◽  
Anterior Cervical Plate

Abstract Background: To analyze the causes of cervical adjacent segment degenerative disease (ASDis), explore the surgical results of longitudinal spinous-splitting laminoplasty with coral bone (SLAC) during cervical reoperation, and accumulate data on reoperation with SLAC in a primary hospital.Methods: We conducted a retrospective study. From 1998 to 2014, 52 patients underwent cervical reoperation for ASDis using SLAC at our hospital. Among them, 39 were treated with anterior cervical fusion and internal fixation in the first operation (anterior cervical corpectomy with fusion [ACCF], n=24; anterior cervical discectomy and fusion [ACDF], n=11; and cervical disc arthroplasty [CDA], n=4).Results: In patients who underwent an anterior cervical approach in the first instance, ASDis was significantly higher in the C3/4 gap than in other gaps. In the ACCF group, the lateral radiograph of the cervical spine revealed that the distance between the anterior cervical plate and adjacent segment disc in15 cases (62.5%) was <5 mm, and five cases (12.8%) had internal fixation screws that broke into the annulus of the adjacent segment. After the first SLAC, ASDis occurred in C2/3 and C3/4 in four (30.8%) and eight cases (61.5%), respectively. Post-reoperation, all cases were follow-up for >5 (average, 6.2) years. Comparing pre-reoperation and last follow-up values, the mean Japanese Orthopedic Association score was 10.2±1.5 versus15.5±0.7 (P=0.03), neck disability index was 26.2 versus13.6 points (P=0.01), upper-limb visual analog scale (VAS) score was 6.1 versus2.6 points (P=0.04), and neck and shoulder VAS score was 6.6 versus 2.1 points (P=0.03).Conclusions: ASDis was primarily caused by 1) a distance of <5 mm between the anterior cervical plate and adjacent segment disc and 2) the screw breaking through the adjacent segmental annulus. SLAC proved to be a simple technique, with clear local anatomy and satisfactory clinical results.

Artificial disc replacement and adjacent-segment pathology: 10-year outcomes of a randomized trial

2021 ◽  
pp. 1-9
Keyword(s):  
Surgical Procedures ◽  
Disc Replacement ◽  
Adjacent Segment ◽  
Artificial Disc ◽  
Anterior Decompression ◽  
Fusion Surgery ◽  
Follow Up Study ◽  
Artificial Disc Replacement ◽  
Flexion Extension

OBJECTIVE Artificial disc replacement (ADR) is designed to preserve motion and thus protect against adjacent-segment pathology (ASP) and act as an alternative treatment to fusion surgery. The question remains, how well do ADR devices perform after 10 years of follow-up compared with fusion surgery in terms of patient satisfaction, sustainability, and protection against ASP? METHODS This was the 10-year follow-up study of 153 participants who underwent ADR or fusion surgery after anterior decompression due to cervical degenerative radiculopathy (ISRCTN registration no. 44347115). Scores on the Neck Disability Index (NDI), EQ-5D, and visual analog scale for neck and arm pain were obtained from the Swedish Spine Registry and analyzed using ANCOVA. Information about secondary surgical procedures was collected from medical records and presented as Kaplan-Meier curves. MRI and flexion-extension radiography were performed, and ASP was graded according to the Miyazaki classification system. RESULTS Ten participants were lost to follow-up, which left 143 participants (80 underwent ADR and 65 underwent anterior cervical discectomy and fusion). There were no differences between groups in terms of patient-reported outcome measures (10-year difference in NDI scores 1.7 points, 95% CI −5.1 to 8.5, p = 0.61). Nineteen (24%) participants in the ADR group compared with 9 (14%) in the fusion group underwent secondary surgical procedures. The higher reoperation rate of the ADR group was mainly due to 11 female participants with device loosening. The rates of reoperation due to ASP were similar between groups, which was confirmed with MRI assessment of ASP that also showed no differences between the groups (p = 0.21). CONCLUSIONS This was the first 10-year follow-up study to compare ADR with fusion surgery and to provide MRI information for the assessment of ASP. The authors found no benefit of ADR over fusion surgery after anterior decompression for cervical degenerative radiculopathy.

scholarly journals Medium-term effects of Dynesys dynamic stabilization versus posterior lumbar interbody fusion for treatment of multisegmental lumbar degenerative disease

2017 ◽  
Vol 45 (5) ◽  
pp. 1562-1573 ◽  
Author(s):  
Haiting Wu ◽  
Qingjiang Pang ◽  
Guoqiang Jiang
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Degenerative Disease ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Medium Term ◽  
Lumbar Degenerative Disease ◽  
Radiographic Outcomes

Objective To compare the medium-term clinical and radiographic outcomes of Dynesys dynamic stabilization and posterior lumbar interbody fusion (PLIF) for treatment of multisegmental lumbar degenerative disease. Methods Fifty-seven patients with multisegmental lumbar degenerative disease underwent Dynesys stabilization (n = 26) or PLIF (n = 31) from December 2008 to February 2010. The mean follow-up period was 50.3 (range, 46–65) months. Clinical outcomes were evaluated using a visual analogue scale (VAS) and the Oswestry disability index (ODI). Radiographic evaluations included disc height and range of motion (ROM) of the operative segments and proximal adjacent segment on lumbar flexion-extension X-rays. The intervertebral disc signal change was defined by magnetic resonance imaging, and disc degeneration was classified by the Pfirrmann grade. Results The clinical outcomes including the VAS score and ODI were significantly improved in both groups at 3 months and the final follow-up, but the difference between the two was not significant. At the final follow-up, the disc height of stabilized segments in both groups was significantly increased; the increase was more notable in the Dynesys than PLIF group. The ROM of stabilized segments at the final follow-up decreased from 6.20° to 2.76° and 6.56° to 0.00° in the Dynesys and PLIF groups, respectively. There was no distinct change in the height of the proximal adjacent segment in the two groups. The ROM of the proximal adjacent segment in both groups increased significantly at the final follow-up; the change was significantly greater in the PLIF than Dynesys group. Only one case of adjacent segment degeneration occurred in the PLIF group, and this patient underwent a second operation. Conclusions Both Dynesys stabilization and PLIF can improve the clinical and radiographic outcomes of multisegmental lumbar degenerative disease. Compared with PLIF, Dynesys stabilization can maintain the mobility of the stabilized segments with less influence on the proximal adjacent segment and may help to prevent the occurrence of adjacent segment degeneration. Dynesys is reliable for the treatment of multisegmental lumbar degenerative disease at the medium-term follow-up.

Sign in / Sign up

Export Citation Format

Share Document