K-rod dynamic internal fixation versus microendoscopic discectomy for the treatment of single-segment lumbar disc herniation

Qu, Yang; Cheng, Meng Ru; Dong, Ran; Kang, Mingyang; Zhou, Hongyang; Zhao, Jianwu

doi:10.1177/2309499017742740

Cited by 13 publications

(13 citation statements)

References 21 publications

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“…Furthermore, it can preserve the ROM of the surgically corrected segment, thus reducing the stress load on the adjacent segments and compensating the ROM [20,21]. Other studies have also supported the view that the dynamic stabilization system can reduce ASD [22][23][24]. In this study, the total lumbar ROM of the Isobar TTL group at the last follow-up was significantly greater than that of the rigid group, indicating that Isobar TTL helps retain a certain degree of the total lumbar ROM.…”

Section: Discussionsupporting

confidence: 70%

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

Yang

et al. 2020

BMC Surg

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Background: Nonfusion fixation is an effective way to treat lumbar degeneration. In the present study, we analyzed the clinical effects and radiographic outcomes of the Isobar TTL system used to treat two-segment lumbar degenerative disease. Method: Forty-one patients diagnosed with two-segment lumbar degenerative disease underwent surgical implantation of the Isobar TTL dynamic stabilization system (n = 20) or a rigid system (n = 21) from January 2013 to June 2017. The mean follow-up time was 23.6 (range 15-37) months. Clinical results were evaluated with the Oswestry Disability Index (ODI), modified Macnab criteria, and the visual analog score (VAS). Radiographic evaluations included the height of the intervertebral space and the range of motion (ROM) of the treated and adjacent segments. The intervertebral disc signal was classified using the modified Pfirrmann grading system and the University of California at Los Angeles (UCLA) system. Results: The clinical results, including the ODI and VAS, showed that there was significant improvement in the two groups after implantation and that the difference between the two groups was not significant. In addition, the clinical efficacy indicated by the modified Macnab criteria for the two groups was similar. Radiological outcomes included the height of the intervertebral space, lumbar mobility, and intervertebral disc signal. The height of the intervertebral space of the upper adjacent segment L2/3 in the rigid group was significantly lower than that in the Isobar TTL group at the last follow-up. Furthermore, the number of ROMs of the fixed-segment L3/4 in the Isobar TTL group was significantly less than that before implantation, suggesting that the fixed-segment ROMs in the Isobar TTL group were limited. In addition, the ROM of the upper adjacent segment L2/3 in the last follow-up of the rigid group increased significantly, while that of the Isobar TTL group did not change after implantation. Finally, the incidence of adjacent-segment degeneration (ASD) was significantly greater in the rigid group than in the Isobar TTL group according to the UCLA system. Conclusion: The Isobar TTL system can be clinically effective for treating two-segment lumbar degenerative disease. Compared with rigid fixation, the Isobar TTL system yielded better radiographic outcomes and maintained the mobility of the treated segments with less impact on the proximal adjacent segment.

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Section: Discussionsupporting

confidence: 70%

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

Yang

et al. 2020

BMC Surg

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“…The ROM of the operative segment was also preserved, which reduced stress on the segments, and provided a compensation of the ROM [21,26]. Dynamic K-Rod stabilization delays the occurrence of adjacent-level degeneration [11,13,16]. Due to the relatively short follow-up time of this study, it will take longer and more follow-up to further confirm the reliability of the results.…”

Section: Radiologic Outcomes Of Typical Casementioning

confidence: 81%

Clinical efficacy and radiographic K-Rod stabilization for the treatment of multilevel degenerative lumbar spinal stenosis

Fu¹,

Chen²,

Yang³

et al. 2020

Preprint

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Background: This study compares the use of radiographic K-Rod dynamic stabilization to the rigid system for the treatment of multisegmental degenerative lumbar spinal stenosis (MDLSS).Methods: A total of 40 patients with MDLSS who underwent surgical treatment using the K-Rod (n=25) and rigid systems (n=15) from March 2013 to March 2017 were assessed. The mean follow-up period was 29.1 months. JOA, ODI, VAS and modified Macnab were assessed. Radiographic evaluations included lumbar lordosis angle, ISR value, operative and proximal adjacent ROM. Changes in intervertebral disc signal were classified according to Pfirrmann grade and UCLA system. Results: JOA, ODI and VAS changed significantly after the operation to comparable levels between the groups. However, the lumbar lordosis significantly decreased at final follow-up between both groups. The ROM of the proximal adjacent segment increased at final follow-up, but the number of fixed segment ROMs in the K-Rod group were significantly lower at the final follow-up than observed prior to the operation. In both groups, the ISR of the proximal adjacent segment decreased, most notably in the rigid group. The ISR of the non-fusion fixed segments in the K-Rod group increased post-operation and during final follow-up. The levels of adjacent segment degeneration were higher in the rigid group vs. the K-Rod group according to modified Pfirrmann grading and the UCLA system. Conclusions: Compared with the rigid system for treatment of MDLSS, dynamic K-Rod stabilization achieves improved radiographic outcomes and improves the mobility of the stabilized segments, minimizing the influence on the proximal adjacent segment.

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“…Thereby, the relevant functional activities could be performed earlier after the operation, which signi cantly shortened the postoperative hospital-stay duration. Recent studies have shown that both the methods can provide bene cial short-term effects (21)(22). On the contrary, spinal fusion is performed for coping with lumbar instability in the PLIF procedure, which can be attributed to some complications such as adjacent segment diseases (ASD) (3,(5)(6), considering that the spinal fusion may change the rotation center over the disc, increasing the stress on the intervertebral disc of the adjacent mobile segments (23).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Posterior Lumbar Dynamic Fixation and Intervertebral Fusion on Paraspinal Muscles

Lin

Wang

Xiang

et al. 2021

Preprint

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Background: The aim of this study was to analyze the effect of unilateral K-rod dynamic internal fixation on paraspinal muscles for lumbar degenerative diseases. Methods: This study retrospectively collected 52 patients who underwent lumbar surgery with the K-rod group or PLIF. The operation time, intraoperative blood loss, postoperative drainage volume, postoperative exercise time were compared in the two groups. The visual analog scale (VAS) score and the oswestry dysfunction index (ODI) were employed to evaluate the clinical outcomes. The functional cross-sectional area (FCSA) of the paraspinal muscles and paraspinal muscles fat infiltration were measured to assess on the paraspinal muscles. Results: As compared with the PLIF group, the operation time, the postoperative time in the field, and the average postoperative hospital stay in the K-rod internal fixation group were significantly shortened. At the last follow-up, both the groups showed significant improvement in the VAS score and ODI. The FCSA atrophy of the upper and lower adjacent segments (UAS and LAS) of the K-rod internal group was significantly less than that of the PLIF group. The extent of increase in the fatty infiltration of the paraspinal muscles in the K-rod group was significantly lesser than that in the PLIF group. The postoperative low back pain of the two groups of patients was significantly positively correlated with the FCSA atrophy.Conclusions: As compared to PLIF, the posterior lumbar unilateral K-rod dynamic internal fixation showed significantly lesser paraspinal muscle atrophy and fatty infiltration, which were significantly positively correlated with postoperative low back pain.

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K-rod dynamic internal fixation versus microendoscopic discectomy for the treatment of single-segment lumbar disc herniation

Abstract: K-rod internal fixation and MED produce satisfactory outcomes in the treatment of single-segment lumbar disc herniation. K-rod internal fixation is superior to MED in preventing adjacent segment degeneration.

Cited by 13 publications

References 21 publications

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

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

Clinical efficacy and radiographic K-Rod stabilization for the treatment of multilevel degenerative lumbar spinal stenosis

The Effect of Posterior Lumbar Dynamic Fixation and Intervertebral Fusion on Paraspinal Muscles

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