Kim Do-Keun, Lim Hyunkeun, Rim Dae Cheol, Oh Chang Hyun
Department of Neurosurgery, Inha University School of Medicine, Incheon, Korea.
Department of Anesthesiology & Pain Medicine, Inha University School of Medicine, Incheon, Korea.
Korean J Spine. 2016 Jun;13(2):57-62. doi: 10.14245/kjs.2016.13.2.57. Epub 2016 Jun 30.
Spinal fusion operation is an effective treatment in the spinal pathology, but it could change the physiological distribution of load at the instrumented and adjacent segments. This retrospective study compared the radiological and clinical outcomes of patients undergoing lumbar fusion with semirigid rods versus rigid rods system.
Using transpedicular fixation and posterior lumbar interbody fusion at the level of L4/L5, 20 patients were treated with semirigid rods (WavefleX, SR group), and 20 patients with rigid rods (titanium, RR group). Clinical and radiological outcomes were evaluated, including visual analog score for lower back pain and leg pain, Prolo functional and economic scores, statues of implanted instruments, fusion rate, and complications during 24-month follow-up.
Clinical scores were significantly improved until postoperative 24-month follow-up as compared with preoperative scores in both groups (p<0.05), with similar levels of improvement observed at the same time points postoperatively between the 2 groups. Prolo economic scores were significantly improved in SR group compared to RR until 12 months, but this improvement became similar after 18 months. The overall fusion rate was 94.1% until the 24-month follow-up for both groups. No significant complication was observed in both groups.
The results of the present study indicate that semirigid rods system with posterior lumbar interbody fusion showed similar clinical and radiological result with rigid rods system until 2 years after instrumentation. The WavefleX rods system, as a semirigid rods with unique characteristics, may be an effective alternative treatment for patients in lumbar fusion.
脊柱融合手术是治疗脊柱疾病的一种有效方法,但它会改变植入节段及相邻节段的生理负荷分布。本回顾性研究比较了接受半刚性棒与刚性棒系统腰椎融合术患者的影像学和临床结果。
在L4/L5节段采用经椎弓根固定和后路腰椎椎间融合术,20例患者采用半刚性棒(WavefleX,SR组)治疗,20例患者采用刚性棒(钛合金,RR组)治疗。评估临床和影像学结果,包括下腰痛和腿痛的视觉模拟评分、普罗洛功能和经济评分、植入器械状态、融合率以及24个月随访期间的并发症。
与术前评分相比,两组患者术后24个月随访时临床评分均显著改善(p<0.05),两组术后相同时间点的改善水平相似。与RR组相比,SR组普罗洛经济评分在12个月时显著改善,但18个月后这种改善变得相似。两组24个月随访时总体融合率均为94.1%。两组均未观察到明显并发症。
本研究结果表明,后路腰椎椎间融合术采用半刚性棒系统与刚性棒系统在器械植入后2年内显示出相似的临床和影像学结果。WavefleX棒系统作为一种具有独特特性的半刚性棒,可能是腰椎融合患者的一种有效替代治疗方法。