Erdogan Uzay, Berikol Gurkan, Albas Ibrahim Taha, Akgun Mehmet Yigit, Oktenoglu Tunc, Ates Ozkan, Ozer Ali Fahir
Department of Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul 43606, Turkey.
Department of Neurosurgery, Health Sciences University, Sincan Training and Research Hospital, Ankara 06949, Turkey.
Diagnostics (Basel). 2025 Jul 28;15(15):1887. doi: 10.3390/diagnostics15151887.
: This study aimed to compare the clinical and radiological outcomes of dynamic rod stabilization with and without transforaminal lumbar interbody fusion (TLIF) in patients undergoing surgery for degenerative lumbar instability. Specifically, we evaluated the prognostic value of hybrid systems in reducing adjacent segment disease (ASD), enhancing fusion rates, and improving functional outcomes. : A retrospective analysis was conducted on 62 patients treated between 2019 and 2022. Group 1 ( = 34) underwent dynamic rod stabilization alone, while Group 2 ( = 28) received dynamic stabilization combined with TLIF. Radiological assessments included disk height index (DHI) and fusion rates. Clinical outcomes were measured using the Visual Analog Scale (VAS) for back and leg pain at baseline, 12, and 24 months. Statistical analysis was performed using Jamovi software (version 2.4.1). : The hybrid group (dynamic + TLIF) demonstrated significantly higher anterior fusion rates ( < 0.001) and greater improvement in VAS scores for back ( = 0.005) and leg pain ( < 0.001) at 12 months. Although operative time was longer ( = 0.002), there was no significant difference in hospital stay ( = 0.635). No significant differences were observed in ASD development ( = 0.11) or pseudoarthrosis ( = 0.396). The hybrid group maintained better lumbar lordosis and higher adjacent segment DHI. : Hybrid dynamic stabilization combined with TLIF provides superior clinical outcomes and fusion rates compared to dynamic stabilization alone, without significantly increasing the risk of ASD. These findings support the use of hybrid constructs as a balanced strategy for treating degenerative lumbar instability.
本研究旨在比较在接受退行性腰椎不稳手术的患者中，动态棒稳定术联合或不联合经椎间孔腰椎椎体间融合术（TLIF）的临床和影像学结果。具体而言，我们评估了混合系统在减少相邻节段疾病（ASD）、提高融合率和改善功能结果方面的预后价值。
对2019年至2022年期间治疗的62例患者进行了回顾性分析。第1组（n = 34）仅接受动态棒稳定术，而第2组（n = 28）接受动态稳定术联合TLIF。影像学评估包括椎间盘高度指数（DHI）和融合率。使用视觉模拟量表（VAS）在基线、12个月和24个月时测量背部和腿部疼痛的临床结果。使用Jamovi软件（版本2.4.1）进行统计分析。
混合组（动态 + TLIF）在12个月时显示出显著更高的前路融合率（P < 0.001），背部（P = 0.005）和腿部疼痛（P < 0.001）的VAS评分改善更大。虽然手术时间更长（P = 0.002），但住院时间没有显著差异（P = 0.635）。在ASD发展（P = 0.11）或假关节形成（P = 0.396）方面未观察到显著差异。混合组保持了更好的腰椎前凸和更高的相邻节段DHI。
与单独的动态稳定术相比，混合动态稳定术联合TLIF提供了更好的临床结果和融合率，而不会显著增加ASD的风险。这些发现支持使用混合结构作为治疗退行性腰椎不稳的平衡策略。
