Analysis of clinical effect and radiographic outcomes of Isobar TTL system for two-segment lumbar degenerative disease: a retrospective study

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.

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

10.21203/rs.2.14254/v2 ◽

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.

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

10.21203/rs.2.14254/v1 ◽

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.

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Comparison of Clinical and Radiographic Results Between Posterior Pedicle-Based Dynamic Stabilization and Posterior Lumbar Intervertebral Fusion for Lumbar Degenerative Disease: A 2-Year Retrospective Study

World Neurosurgery ◽

10.1016/j.wneu.2018.02.192 ◽

2018 ◽

Vol 114 ◽

pp. e403-e411 ◽

Cited By ~ 3

Author(s):

Haiying Wang ◽

Bing Lv

Keyword(s):

Retrospective Study ◽

Dynamic Stabilization ◽

Degenerative Disease ◽

Lumbar Degenerative Disease ◽

Intervertebral Fusion

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Comparison of clinical and radiographic results between isobar posterior dynamic stabilization and posterior lumbar inter-body fusion for lumbar degenerative disease: A four-year retrospective study

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2015.06.003 ◽

2015 ◽

Vol 136 ◽

pp. 100-106 ◽

Cited By ~ 11

Author(s):

Yi Yang ◽

Ying Hong ◽

Hao Liu ◽

Yueming Song ◽

Tao Li ◽

...

Keyword(s):

Retrospective Study ◽

Dynamic Stabilization ◽

Degenerative Disease ◽

Lumbar Degenerative Disease ◽

Posterior Dynamic Stabilization

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Evaluating Minimally Invasive Spine Surgery With Midline Cortical Bone Trajectory Screw Fixation for Lumbar Degenerative Disease in a Retrospective Study of 200 Patients

Neurospine ◽

10.14245/ns.2142016.008 ◽

2021 ◽

Vol 18 (2) ◽

pp. 355-362

Author(s):

Sung Hyun Noh ◽

Ho Yeol Zhang

Keyword(s):

Retrospective Study ◽

Minimally Invasive ◽

Cortical Bone ◽

Spine Surgery ◽

Screw Fixation ◽

Degenerative Disease ◽

Minimally Invasive Spine Surgery ◽

Lumbar Degenerative Disease ◽

Cortical Bone Trajectory ◽

Minimally Invasive Spine

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

Journal of International Medical Research ◽

10.1177/0300060517708104 ◽

2017 ◽

Vol 45 (5) ◽

pp. 1562-1573 ◽

Cited By ~ 10

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.

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