Adjustments of Aspect Joints after Dynamic Stabilization: Steady Degeneration or Gradual Fusion?
World Neurosurg. 2018 Jan 27;:
Authors: Yeh MY, Kuo CH, Wu JC, Huang WC, Tu TH, Fay LY, Wu CL, Cheng H
BACKGROUND: The non-fusion pedicle-screw system Dynesys stabilization(DS) for lumbar degenerative illness goals to higher preservation of vary of movement(ROM) than fixation and fusion methods. Nevertheless, decreased ROM and sudden aspect fusion on the index degree had been noticed after DS utilized with unknown etiology. The purpose of this research is utilizing radiological parameters to clarify the phenomenon of aspect arthrodesis.
METHODS: The sufferers who underwent surgical procedure for L4-5 spinal stenosis had been sorted retrospectively into two teams: the DS, and the microdisectomy(MicD) teams. Radiological parameters together with aspect degeneration, evaluated by computed tomography(CT) or magnetic resonance picture(MRI), and ROM by dynamic radiographs, had been in contrast perioperatively. A linear regression mannequin was fitted all to information factors to calculate correlation over time. Put up-operative aspect arthrodesis?at?the?index?degree was detected by CTs. Purposeful outcomes had been additionally in contrast between teams.
RESULTS: A complete of 61 sufferers (DS:MicD=38:23) had been adopted 36.9+16.eight months post-operatively. After surgical procedure, each teams of sufferers had vital medical enchancment with out distinction between two teams (all p>zero.05). Within the DS group, considerably decreased ROM was noticed after 24-month follow-up (p < zero.05). The correlation coefficient of aspect degeneration over time and the aspect fusion fee within the DS group had been each considerably larger than these within the MicD group (each p< zero.05).
CONCLUSIONS: The sufferers who underwent DS for L4-5 grade I spondylolisthesis skilled considerably diminished ROM and a constructive correlation of aspect degeneration over time post-operatively. The restricted ROM on the index degree might be a possible threat of aspect degeneration and trigger sudden arthrodesis.
PMID: 29382613 [PubMed – as supplied by publisher]