Department of Orthopaedic Surgery, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, 200011, Shanghai, People's Republic of China.
Arch Orthop Trauma Surg. 2014 May;134(5):605-10. doi: 10.1007/s00402-014-1961-4. Epub 2014 Feb 23.
To prospectively evaluate the functional and radiological outcomes of Isobar semi-rigid dynamic posterior stabilization adjacent to single-level fusion up to and including 24 months postoperatively.
A prospective follow-up for 24 months of 36 patients who underwent posterior Isobar dynamic stabilization due to single-level degenerative lumbar discopathy and instability (DLDI) with mild adjacent level degeneration, with collection of functional [visual analog scale (VAS) and Oswestry Disability Index (ODI)] and radiological data (resting, functional X-rays and MRI).
Functional outcomes at 24 months showed significant improvement in mean VAS score by 38.9 points (P < 0.01) and ODI by 22.4 points (P < 0.01). Compared with data preoperatively, disc height at the index and adjacent levels and intervertebral angle (IVA) at the index level showed a slight decreasing trend at each follow-up (P > 0.05), while IVA at the adjacent level showed a slight increasing trend (P > 0.05). Range of motion averaged 2.84° at the index level and remained unchanged at the adjacent level (P > 0.05). The mean Pfirrmann score changed from 2.86 preoperatively to 2.92 at 24 months postoperatively at the index level (P > 0.05), and from 1.92 preoperatively to 1.96 at 24 months postoperatively at the adjacent level (P > 0.05). No reoperation, loosening of screws or infection was recorded.
Patients with single-level DLDI and mild adjacent level degeneration treated with Isobar stabilization show a clinical improvement after 2 years. However, disc degeneration at the index and adjacent levels seems to continue despite using semi-rigid dynamic stabilization.
前瞻性评估 Isobar 半刚性动态后稳定系统在单节段融合及以上至术后 24 个月的功能和影像学结果。
对 36 例因单节段退行性腰椎间盘病和不稳定（DLDI）合并轻度相邻节段退变而行后路 Isobar 动态稳定的患者进行了 24 个月的前瞻性随访，收集了功能（视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI））和影像学数据（静息、功能 X 线和 MRI）。
24 个月时的功能结果显示，VAS 评分平均改善 38.9 分（P < 0.01），ODI 评分改善 22.4 分（P < 0.01）。与术前数据相比，在每次随访时，指数和相邻节段的椎间盘高度以及指数节段的椎间角（IVA）均呈轻微下降趋势（P > 0.05），而相邻节段的 IVA 呈轻微上升趋势（P > 0.05）。指数节段的平均活动度为 2.84°，在相邻节段保持不变（P > 0.05）。Pfirrmann 评分从术前的 2.86 分平均改善至术后 24 个月的 2.92 分（P > 0.05），在相邻节段从术前的 1.92 分平均改善至术后 24 个月的 1.96 分（P > 0.05）。没有再次手术、螺钉松动或感染的记录。
对于单节段 DLDI 合并轻度相邻节段退变的患者，使用 Isobar 稳定系统治疗 2 年后，临床症状有所改善。然而，尽管使用半刚性动态稳定系统，指数和相邻节段的椎间盘退变似乎仍在继续。
