Oktenoglu T, Ozer A F, Sasani M, Kaner T, Canbulat N, Ercelen O, Sarioglu A C
American Hospital, Neurosurgery Department, Istanbul, Turkey.
Minim Invasive Neurosurg. 2010 Jun;53(3):112-6. doi: 10.1055/s-0030-1262810. Epub 2010 Aug 31.
A prospective pilot study was designed to evaluate the role of a posterior dynamic stabilization technique in the surgical treatment of degenerative disc disease. Posterior dynamic stabilization with a hinged screw is a new concept in the surgical treatment of degenerative disc disease of the lumbar spine. The traditional surgical treatment is to apply a fusion procedure. However, numerous reports showed unsatisfactory clinical outcomes even when patients have satisfactory radiological outcomes following fusion procedures.
The study included patients who were surgically treated with a dynamic stabilization technique due to painful degenerative disc disease. Clinical and radiological findings for the 20 participating patients were analyzed in a 2-year follow-up study. Preoperative and postoperative data at the 3 (rd), 12 (th) and 24 (th) month were collected for both clinical and radiological outcomes. Statistical analyses between preoperative and postoperative data were performed using the Wilcoxon test.
The clinical outcome measurements (VAS, ODI) showed significant improvement in all postoperative measurements compared to preoperative values. The mean preoperative visual analogue score (VAS, 7.9) and Oswestry Disability Index (ODI 59.2) significantly decreased to 0.8 for VAS and 9.2 for ODI, at 2 years post-operation (p<0.05). The radiological studies showed no significant changes between pre- and postoperative values, in all parameters. There was no mortality or morbidity.
The results of this pilot study are encouraging. Dynamic stabilization may be an effective technique in the surgical treatment of painful degenerative disc disease. A larger series study, with longer follow-up periods and with control groups is needed to determine the success and safety of posterior dynamic stabilization in the surgical treatment of degenerative disc disease.
一项前瞻性试验性研究旨在评估一种后路动态稳定技术在退行性椎间盘疾病外科治疗中的作用。带铰链螺钉的后路动态稳定是腰椎退行性椎间盘疾病外科治疗中的一个新概念。传统的外科治疗是采用融合手术。然而,大量报告显示,即使患者在融合手术后影像学结果令人满意,其临床结果仍不尽人意。
该研究纳入了因疼痛性退行性椎间盘疾病接受动态稳定技术手术治疗的患者。在一项为期2年的随访研究中,对20名参与研究的患者的临床和影像学检查结果进行了分析。收集了第3、12和24个月的术前和术后临床及影像学结果数据。术前和术后数据之间的统计分析采用Wilcoxon检验。
临床结果测量指标(视觉模拟评分法[VAS]、Oswestry功能障碍指数[ODI])显示,与术前值相比,所有术后测量指标均有显著改善。术后2年,术前平均视觉模拟评分(VAS,7.9)和Oswestry功能障碍指数(ODI 59.2)显著降至VAS为0.8,ODI为9.2(p<0.05)。影像学研究显示,所有参数的术前和术后值之间均无显著变化。无死亡或发病情况。
这项试验性研究的结果令人鼓舞。动态稳定可能是治疗疼痛性退行性椎间盘疾病的一种有效技术。需要进行一项更大规模的系列研究,随访期更长并设有对照组,以确定后路动态稳定在退行性椎间盘疾病外科治疗中的成功率和安全性。