Çakir Tayfun, Çakir Mürteza, Okay Hilmi Önder, Yolaş Coşkun, Tanriverdi Osman, Ömeroğlu Muhammed, Arslan Yusuf Kemal
Department of Neurosurgery, Erzincan University Medical Faculty.
Department of Neurosurgery, Atatürk University Medical Faculty.
Medicine (Baltimore). 2018 Dec;97(52):e13854. doi: 10.1097/MD.0000000000013854.
Low back and leg pain due to lumbar discal hernia (LDH) is an important health issue. Current evidences support surgery in carefully selected patients who have failed conservative treatment and do not exhibit any psychosocial overlay. However, as known, sometimes it may be still very difficult to normalize the life qualities of patients for long times. Now different surgical methods for LDH are in use with new technological materials. One of them is lumbar disc prosthesis. In this study, the radiological and clinical effects of using lumbar disc prosthesis were evaluated with comparing patients underwent simple lumbar microdsicectomy. The purpose of this study is to reveal whether inserting the disc prosthesis into the intervertebral distance after lumbar microdiscectomy is beneficial or not both radiologically and clinically.
A total of 114 patients were analyzed; the first cohort consisted of 57 patients who received a lumbar discectomy at a single level along with the implantation of a disc prosthesis and the second consisted of 57 patients only received a lumbar discectomy at a single level. These 2 groups were studied by comparing the disc space on the level of carried out operations with pain scales, foramen diameters of coming about related roots preoperatively and postoperatively at 3 years.
One of the significant results of the implementation of the disc prosthesis is fulfilment of a healthy disc height again after microdiscectomy due to LDH. We concluded that fulfilment of a healthy disc height with lumbar disc prosthesis was clinically beneficial for patients underwent microdiscectomy.
Based on the results obtained in this study, it can be concluded that the implantation of a disc prosthesis in appropriate patients is more favorable regarding pain and spinal physiology when compared to simple microdiscectomy.
腰椎间盘突出症（LDH）所致的腰腿痛是一个重要的健康问题。目前的证据支持在经过精心挑选、保守治疗失败且不存在任何心理社会叠加因素的患者中进行手术。然而，众所周知，有时长期使患者的生活质量恢复正常可能仍然非常困难。现在，随着新技术材料的出现，针对LDH有不同的手术方法在使用。其中之一是腰椎间盘假体。在本研究中，通过比较接受单纯腰椎显微椎间盘切除术的患者，评估了使用腰椎间盘假体的放射学和临床效果。本研究的目的是揭示在腰椎显微椎间盘切除术后将椎间盘假体植入椎间隙在放射学和临床上是否有益。
共分析了114例患者；第一组由57例接受单节段腰椎间盘切除术并植入椎间盘假体的患者组成，第二组由57例仅接受单节段腰椎间盘切除术的患者组成。通过比较手术节段的椎间盘间隙、疼痛量表、术前和术后3年相关神经根的椎间孔直径，对这两组进行研究。
椎间盘假体植入的一个显著结果是，因LDH行显微椎间盘切除术后再次实现了健康的椎间盘高度。我们得出结论，腰椎间盘假体实现健康的椎间盘高度对接受显微椎间盘切除术的患者在临床上是有益的。
基于本研究获得的结果，可以得出结论，与单纯显微椎间盘切除术相比，在合适的患者中植入椎间盘假体在疼痛和脊柱生理方面更有利。
