Wang Haiying, Lv Bing
Department of Orthopaedic Surgery, Baoding No.1 Central Hospital, Baoding, Hebei, China.
Department of Orthopaedic Surgery, Baoding No.1 Central Hospital, Baoding, Hebei, China.
World Neurosurg. 2018 Jun;114:e403-e411. doi: 10.1016/j.wneu.2018.02.192. Epub 2018 Mar 10.
To compare outcomes between K-rod dynamic stabilization system (KDSS) and posterior lumbar intervertebral fusion (PLIF) for lumbar degenerative disease.
This study retrospectively reviewed 98 patients who underwent lumbar surgery from March 2012 to June 2014, including 48 in the KDSS group and 50 in the PLIF group. All patients were followed up for at least 2 years. Duration of operation, blood loss, hospital stay, complications, and patient satisfaction were recorded and analyzed. Clinical outcomes were evaluated by visual analog scale and Oswestry Disability Index. Radiographic results including disk height index, foraminal height, and range of motion (ROM) were compared between groups.
Compared with PLIF group, KDSS group had shorter duration of operation and less blood loss (P < 0.001). There were no differences in hospital stay, complications, and patient satisfaction. Both groups demonstrated significant improvement in visual analog scale back and leg pain and Oswestry Disability Index. No significant difference was found between groups at any time point (P > 0.05). Postoperative disk height index and foraminal height increased significantly compared with preoperatively (P < 0.05). Although disk height index and foraminal height in KDSS group were smaller than PLIF group values, there were no significant differences between groups. ROM of total lumbar and implanted segment was decreased compared with preoperative ROM in both groups (P < 0.05), but the 2 values were higher in KDSS group (P < 0.05).
Both KDSS and PLIF can improve clinical and radiographic outcomes for early-stage lumbar degenerative disease. Compared with PLIF, KDSS has better operative time, less blood loss, and better preservation of ROM, but prospective, randomized, controlled trials with larger sample size and longer follow-up are required.
比较K-rod动态稳定系统（KDSS）与后路腰椎椎间融合术（PLIF）治疗腰椎退行性疾病的疗效。
本研究回顾性分析了2012年3月至2014年6月接受腰椎手术的98例患者，其中KDSS组48例，PLIF组50例。所有患者均随访至少2年。记录并分析手术时间、失血量、住院时间、并发症及患者满意度。采用视觉模拟评分法和Oswestry功能障碍指数评估临床疗效。比较两组间影像学结果，包括椎间盘高度指数、椎间孔高度和活动度（ROM）。
与PLIF组相比，KDSS组手术时间更短，失血量更少（P < 0.001）。住院时间、并发症及患者满意度方面无差异。两组患者的视觉模拟评分法下背部和腿部疼痛及Oswestry功能障碍指数均有显著改善。各时间点两组间差异均无统计学意义（P > 0.05）。与术前相比，术后椎间盘高度指数和椎间孔高度均显著增加（P < 0.05）。虽然KDSS组的椎间盘高度指数和椎间孔高度小于PLIF组，但两组间差异无统计学意义。两组全腰椎和植入节段的ROM均较术前降低（P < 0.05），但KDSS组的这两个值更高（P < 0.05）。
KDSS和PLIF均可改善早期腰椎退行性疾病的临床和影像学疗效。与PLIF相比，KDSS手术时间更短，失血量更少，ROM保留更好，但需要进行样本量更大、随访时间更长的确切随机对照试验。
