Posterior dynamic stabilization for the treatment of patients with lumbar degenerative disc disease: long-term clinical and radiological results

Objective. Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD) of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2. Modic types 1 and 2 degeneration can be painful. Classic approach in such cases is spine fusion. We operated 88 DDD patients with Modic types 1 and 2 via posterior dynamic stabilization. Good results were obtained after 2 years of followup.Methods. A total of 88 DDD patients with Modic types 1 and 2 were selected for this study. The patients were included in the study between 2004 and 2010. All of them were examined with lumbar anteroposterior (AP) and lateral X-rays. Lordosis of the lumbar spine, segmental lordosis, and ratio of the height of the intervertebral disc spaces (IVSs) were measured preoperatively and at 3, 12, and 24 months after surgery. Magnetic resonance imaging (MRI) analysis was carried out, and according to the data obtained, the grade of disc degeneration was classified. The quality of life and pain scores were evaluated by visual analog scale (VAS) score and Oswestry Disability Index (ODI) preoperatively and at 3, 12, and 24 months after surgery. Appropriate statistical method was chosen.Results. The mean 3- and 12-month postoperative IVS ratio was significantly greater than that of the preoperative group (P<0.001). However, the mean 1 and 2 postoperative IVS ratio was not significantly different (P>0.05). Furthermore, the mean preoperative and 1 and 2 postoperative angles of lumbar lordosis and segmental lordosis were not significantly different (P>0.05). The mean VAS score and ODI, 3, 12, and 24 months after surgery, decreased significantly, when compared with the preoperative scores in the groups (P=0.000).Conclusion. Dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2 was effective.

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Novel Minimally Invasive Approaches to Lumbar Degenerative Disc Disease: Direct Lateral Approach to the Lumbar Spine

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0034-1382191 ◽

2014 ◽

Vol 75 (S 01) ◽

Author(s):

J. Boddu ◽

J. Rostron ◽

A. Danison ◽

J. Hamilton

Keyword(s):

Lumbar Spine ◽

Minimally Invasive ◽

Degenerative Disc Disease ◽

Lateral Approach ◽

Disc Disease ◽

Lumbar Degenerative Disc Disease ◽

Degenerative Disc ◽

Direct Lateral Approach

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Posterior Transpedicular Dynamic Stabilization versus Total Disc Replacement in the Treatment of Lumbar Painful Degenerative Disc Disease: A Comparison of Clinical Results

Advances in Orthopedics ◽

10.1155/2013/874090 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Tunc Oktenoglu ◽

Ali Fahir Ozer ◽

Mehdi Sasani ◽

Yaprak Ataker ◽

Cengiz Gomleksiz ◽

...

Keyword(s):

Degenerative Disc Disease ◽

Total Disc Replacement ◽

Clinical Results ◽

Dynamic Stabilization ◽

Disc Replacement ◽

Disc Prosthesis ◽

Disc Disease ◽

Degenerative Disc ◽

Duration Of Surgery ◽

The Mean

Study Design. Prospective clinical study.Objective. This study compares the clinical results of anterior lumbar total disc replacement and posterior transpedicular dynamic stabilization in the treatment of degenerative disc disease.Summary and Background Data. Over the last two decades, both techniques have emerged as alternative treatment options to fusion surgery.Methods. This study was conducted between 2004 and 2010 with a total of 50 patients (25 in each group). The mean age of the patients in total disc prosthesis group was 37,32 years. The mean age of the patients in posterior dynamic transpedicular stabilization was 43,08. Clinical (VAS and Oswestry) and radiological evaluations (lumbar lordosis and segmental lordosis angles) of the patients were carried out prior to the operation and 3, 12, and 24 months after the operation. We compared the average duration of surgery, blood loss during the surgery and the length of hospital stay of both groups.Results. Both techniques offered significant improvements in clinical parameters. There was no significant change in radiologic evaluations after the surgery for both techniques.Conclusion. Both dynamic systems provided spine stability. However, the posterior dynamic system had a slight advantage over anterior disc prosthesis because of its convenient application and fewer possible complications.

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