Nabhan A, Al-Yhary A, Ishak B, Steudel W I, Kollmar O, Steimer O
Department of Neurosurgery, Neurosurgical Department, University of Saarland, Homburg, Germany.
J Long Term Eff Med Implants. 2007;17(3):207-16. doi: 10.1615/jlongtermeffmedimplants.v17.i3.40.
This is a prospective controlled study comparing lumbar spine disc replacement versus fusion for monosegmental degenerative disc disease (DDD). SUMMARY OF BACKGROUND DATA AND OBJECTIVE: Fusion has been reported to be the standard therapy by DDD of the lumbar spine. Due to unsatisfactory long-term results of fusion by progressive adjacent level degeneration, disc replacement was developed and thought to reduce pain while restoring disc height and motion at the affected level. The expected long-term advantage of disc replacement over fusion is the preservation of motion. This again is very difficult to judge; therefore the aim of the current study was to analyze segmental motion following disc replacement versus fusion.
Patients meeting inclusion criteria were consented for the study. This analysis includes data up to 12 months from the first included patients. There were 13 patients who underwent disc replacement, and 11 patients had fusion procedures. Radiostereometric analysis was done 1 and 6 weeks and 3, 6, and 12 months after surgery.
The mobility provocation RSA showed a significant segmental motion in the disc replacement group in comparison to fusion.
Disc replacement using Active L prostheses preserves segmental motion during the period examination time of 12 months.
这是一项前瞻性对照研究，比较腰椎间盘置换术与融合术治疗单节段退变性椎间盘疾病（DDD）的效果。
据报道，融合术一直是腰椎DDD的标准治疗方法。由于融合术长期效果因相邻节段渐进性退变而不尽人意，椎间盘置换术应运而生，并被认为可在恢复患节椎间盘高度和活动度的同时减轻疼痛。椎间盘置换术相对于融合术预期的长期优势在于保留活动度。然而，这一点很难判断；因此，本研究的目的是分析椎间盘置换术与融合术后的节段活动情况。
符合纳入标准的患者同意参与本研究。该分析纳入了首批患者术后长达12个月的数据。13例患者接受了椎间盘置换术，11例患者接受了融合手术。术后1周、6周以及3个月、6个月和12个月进行了放射立体测量分析。
与融合术组相比，活动激发RSA显示椎间盘置换组有显著的节段活动。
在12个月的观察期内，使用Active L假体进行椎间盘置换可保留节段活动度。
