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Endplate modifications after lumbar discectomy with and with out implantation of an annular closure gadget.
Acta Neurochir (Wien). 2018 Feb 02;:
Authors: Barth M, Weiß C, Bouma GJ, Bostelmann R, Kursumovic A, Fandino J, Thomé C
Summary
BACKGROUND: The implantation of a bone-anchored annular closure gadget (ACD) may be related to the developed new endplate modifications (EPC) after surgical procedure.
METHODS: A submit hoc evaluation has been completed in sufferers from a potential randomized multicenter examine. All sufferers underwent restricted lumbar discectomy with intraoperative randomization into the teams restricted lumbar discectomy alone or extra ACD implantation. Low-dose lumbar computed tomography (CT) and scientific investigations had been carried out preoperatively and 12 months after the operation.
RESULTS: A complete of 554 sufferers had been randomized. After exclusion of dropouts, the per-protocol inhabitants included 493 sufferers (251 within the management group and 242 within the ACD group); the follow-up price was ??90%. The variety of sufferers displaying EPC at baseline was related in each teams. The variety of sufferers displaying EPC and the whole EPC lesion space considerably elevated in each teams over time, however considerably elevated extra within the EPC group for the superior and inferior endplate (all P?<?zero.0001). There was no affiliation of pre-existing quantity and dimension of EPC with intercourse, age, or smoking habits. Correlation of scientific variables confirmed no relation with quantity, dimension, and improve of EPC space after surgical procedure.
CONCLUSIONS: Sufferers with major lumbar disc herniation present EPC within the corresponding segments. There’s a important improve of lesion quantity and dimension inside 12 months after discectomy. This improve is considerably extra pronounced within the ACD group. Presence and development of EPC is just not correlated with low-back ache or ODI.
PMID: 29396603 [PubMed – as supplied by publisher]
