Abstract
K-rod-assisted non-fusion surgery for the treatment of lumbar disc herniation has been proven to have short-term clinical efficacy. Meanwhile, its long-term effects have not been examined. To observed the long-term clinical efficacy of K-rod-assisted non-fusion operation, this study retrospectively analyzed 22 patients with lumbar disc (L4/5) herniation who underwent K-rod-assisted non-fusion operation (n = 13) or PLIF (n = 9). They were followed-up for more than 5 years. The operation times and blood loss were significantly reduced in the K-rod group compared to the PLIF group. At the last follow-up, the clinical outcomes of the K-rod group were improved compared to those of the PLIF group as observed by the VAS score, JOABPEQ, and ODI. Imaging outcomes at the last follow-up indicated that the loss of height in the L3/4 and L5/S1 intervertebral space, the ROM of L3/4 and L5/S1, and the incidence of adjacent segment degeneration in the PLIF group were significantly higher than those in the K-rod group. According to Pfirrmann grading, Modic changes, and UCLA grading, the incidence of adjacent segment degeneration was 55.6% in the PLIF group and 15.4% in the K-rod group. Changes in spino-pelvic parameters between the two groups were as follows: pelvic index remained unchanged, pelvic tilt angle increased, and lumbar lordosis and sacral slope decreased. Therefore, compared to PLIF, single-segment lumbar disc herniation using K-rod-assisted non-fusion surgery resulted in better long-term clinical efficacy. Our results demonstrate that this procedure can delay adjacent segment degeneration after lumbar surgery.
Highlights
Posterior lumbar interbody fusion (PLIF) has gradually become the "gold standard" for the surgical treatment of degenerative diseases of the spine, complications such as adjacent segment degeneration (ASD) 1 and postoperative low-back pain, 2 affect the long-term clinical efficacy of the operation
Imaging outcomes at the last follow-up indicated that the loss of height in the L3/4 intervertebral space (0.4±0.9 mm vs. 1.5±0.7 mm, P
Compared to PLIF, single-segment lumbar disc herniation using K-rod-assisted non-fusion surgery resulted in better long-term clinical efficacy
Summary
Posterior lumbar interbody fusion (PLIF) has gradually become the "gold standard" for the surgical treatment of degenerative diseases of the spine, complications such as adjacent segment degeneration (ASD) 1 and postoperative low-back pain, 2 affect the long-term clinical efficacy of the operation. This study aimed to compare the clinical outcomes of K-rod-assisted non-fusion surgery and those of PLIF for the treatment of lumbar disc herniation and the roles of these procedures in delaying the degeneration of adjacent spinal segments. Since the development of internal fixation, posterior lumbar interbody fusion (PLIF) surgery has become the gold standard for the treatment of lumbar disc herniation It has good short-term clinical efficacy, it can result in problems such as postoperative intractable lower back pain and degeneration of adjacent segments. K-rod-assisted non-fusion surgery for the treatment of lumbar disc herniation has been proven to have clinical efficacy; its long-term effects have not been examined
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