Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (44): 8324-8331.doi: 10.3969/j.issn.2095-4344.2012.44.027

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Internal fixation for the treatment of lumbar degenerative scoliosis

Lu Ming, Ma Hua-song, Wang Xiao-ping, Niu Jing, Ren Dong-yun, Zheng Rui, Zhang Jing   

  1. Department of Orthopedics, Military Center for Spine Surgery, the 306th Hospital of PLA, Beijing 100101, China
  • Received:2012-08-03 Revised:2012-09-26 Online:2012-10-28 Published:2012-10-28
  • Contact: Ma Hua-song, Chief physician, Master’s supervisor, Department of Orthopedics, Military Center for Spine Surgery, the 306th Hospital of PLA, Beijing 100101, China
  • About author:Lu Ming☆, M.D., Associated chief physician, Associate professor, Department of Orthopedics, Military Center for Spine Surgery, the 306th Hospital of PLA, Beijing 100101, China luming8788@yahoo.com.cn

Abstract:

BACKGROUND: Lumbar degenerative disease is one of the common orthopedic diseases, and there is controversy on the methods of operation and whether the operation should be preformed.
OBJECTIVE: To analyze the effect of internal fixation on the treatment of lumbar degenerative scoliosis, to assess the development of the patient’s symptoms, lumbar renegade segment and imaging, and to systematic review the literatures related degenerative diseases.
METHODS: A total of 61 patients (30 cases in male and 31 cases in female, the age ranged 42-78, average in 59.02) with lumbar degenerative scoliosis were selected from Department of Orthopedics, the 306th Hospital of PLA during March 2010 to August 2012. Among the 61 patients, 32 patients treated with lumbar posterior decompression and internal fixation and fusion; 29 patients treated with lumbar posterior dynamic system. The postoperative follow-up time was 6-29 months, and average in 16 months. Visual Analogue Scale, Oswestry disability Index and Japanese Orthopaedic Association Scores were used for the preoperative, postoperative and follow-up assessment. The literatures on the treatment of lumbar degenerative scoliosis by internal fixation were screened out, and the experimental methods and the results in the literatures were analyzed in-depth.
RESULTS AND CONCLUSION: The gender and age of the patients were consistent with the incidence of lumbar
degenerative scoliosis and age reported in the literatures. Visual Analogue Scale, Oswestry disability Index and Japanese Orthopaedic Association Scores showed that that there was no statistically significant difference at 1 and 3 months postoperation (P > 0.05); at 1 year postoperation, there was statistically significant difference of Visual Analogue Scale, Oswestry disability Index and Japanese Orthopaedic Association Scores (P < 0.05). Lumbar posterior decompression and internal fixation has the advantages of wide adaptation range, longer clinical application time and higher familiarity degree, it has the disadvantages of poor compliance, heavier degeneration degree of adjacent segments and higher incidence of complications. Dynamic fixation system can not only ensure the stability of internal fixation, but also better play the internal fixation characteristics, and the long-term follow-up showed better compliance for the dynamic fixation, therefore had the therapeutic effect, and retained the activities of the patient's lumbar.

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