Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (44): 7131-7136.doi: 10.3969/j.issn.2095-4344.2015.44.015

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Waveflex elastic fixation and discectomy annulus in repair and reconstruction of spinal stability in patients with lumbar disc herniation

Zhang Zhao-chuan, Jiang Xiao-wei, Dai Wei-xiang, Wu De-hui, Ma Chao, Wang Zhao-hong, Han Meng, Feng Jie, Liu Guang-pu   

  1. Department of Orthopedics, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China
  • Received:2015-09-21 Online:2015-10-22 Published:2015-10-22
  • Contact: Jiang Xiao-wei, M.D., Attending physician, Department of Orthopedics, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China
  • About author:Zhang Zhao-chuan, Studying for doctorate, Attending physician, Department of Orthopedics, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China
  • Supported by:

    a Science and Technology Project Funded by Xuzhou Central Hospital Medical Doctor’s Innovation Team, No.XZB201311.

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Abstract:

BACKGROUND: For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate.

OBJECTIVE: To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed small window nucleus pulposus extirpation associated with annulus repair.
METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar small window nucleuspulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of follow-up study was conducted, including: follow-up analysis of clinical efficacy and complications, collection of low-back pain visual analogue scores, collection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators.

RESULTS AND CONCLUSION: Follow-up visits to the patients were conducted 12-20 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Still in the last follow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaller than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults.
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Lumbar Vertebrae, Intervertebral Disk Displacement, Internal Fixators, Follow-up, Tissue Engineering