BACKGROUND: The short-term effects of dynamic internal fixation and whether dynamic internal fixation system can prevent or delay the process of adjacent level degeneration after lumbar surgery remains in controversy.
Objective: To investigate the short-term clinical effectiveness of single-level Isobar TTL dynamic internal fixation and in the treatment of degenerative lumbar diseases.
Methods: From July 2014 to May 2016, 20 patients who suffered from lumbar degenerative diseases and underwent posterior decompression combined with single-level Isobar TTL dynamic internal fixation , including 11 male patients and 9 female patients, were retrospectively analyzed, the average age of these patients was 47.4. Visual analog scale(VAS), Japanese Orthopaedic Association scores(JOA) and Oswestry disability index(ODI) were used to assess clinical outcomes. Disc height, range of motion(ROM) , and University of California at Los Angeles Grading Scale(UCLA) were measured on X-ray films to evaluate the status of disc degeneration on both dynamic fixed segment(index segment) and superior adjacent segment.
Results: During follow- up, all 20 surgeries were finished successfully without complications. 20 patients were followed from 6 to 27months, with an average of 10.2 months, all the patients showed significant improvements in VAS, JOA and ODI scores(P<0.05). At the latest follow-up the ROM of index-segment appeared to be smaller than preoperative status. The disc height and UCLA classification on the index segment appeared to have no significant difference compared with those preoperatively. The latest follow-up data, including ROM, disc height and UCLA classification of superior adjacent segment appeared to have no significant difference compared with those preoperatively.
Conclusion: Single-level Isobar TTL dynamic internal fixation proved to have satisfactory clinical outcomes when used in the treatment of lumbar degenerative diseases. During follow-up, no accelerated disc degeneration on either index segment or superior adjacent segment is observed.