Abstract
Objective To compare the effect of decompression of the spinal canal with or without discectomy on the clinical efficacy of Dynesys dynamic fixation treatment in lumbar degenerative diseases. Methods A total of 62 patients treated for single-segment lumbar degenerative disease from October 2010 to November 2017 were retrospectively analyzed. All patients underwent decompression of the spinal canal with Dynesys dynamic fixation and were divided into two groups. Twenty-seven patients in group A did not undergo discectomy, and 35 patients in group B underwent discectomy. The intervertebral height, range of motion, Pfirrmann grade of the surgical segment and the upper adjacent segment, function scores, and operation information were compared. Results All patients were followed up for an average of 30.7 ± 11.5 months. At the final follow-up, the intervertebral height and range of motion of the surgical segment decreased significantly in both group A and B (p < 0.05), the range of motion of the upper adjacent segment increased significantly (p < 0.05), and the intervertebral height did not change significantly (p < 0.05). The retained percentages of surgical segment intervertebral height and ROM in group A were significantly better than those in group B (p < 0.05). The intervertebral height (p > 0.05) and range of motion (p < 0.05) of the surgical segment in group A were higher than those in group B. The surgical segment Pfirrmann grading of group A was better than that of group B (p < 0.05). Conclusion Dynesys in the treatment of lumbar degenerative diseases may lead to a good clinical effect. In selected cases without discectomy, the range of motion and intervertebral height may be better preserved, and disc degeneration may be reduced.
Highlights
Lumbar degenerative diseases are among of the common diseases in spinal surgery, including disc herniation, spondylolisthesis, and spinal stenosis
visual analog scale (VAS) and Oswestry disability index (ODI) of group A and B are shown in Table 1. e VAS scores of low back pain and leg pain in both groups were significantly improved after surgery (p < 0.05), the VAS of low back pain in the final follow-up was significantly improved compared with that after surgery (p < 0.05), and the VAS of leg pain was improved, but there was no significant difference (p > 0.05)
At the final follow-up, the intervertebral height and range of motion (ROM) of the surgical segment decreased significantly in both groups (p < 0.05). e intervertebral height of the surgical segment at the final follow-up in group A was higher than that in group B (p > 0.05), and the ROM was significantly higher than that of group B (p < 0.05). e retained percentages of surgical segment intervertebral height and ROM in group A were significantly better than those in group B (p < 0.05). ere was no significant change in the intervertebral height of the upper adjacent segment in groups A and B (p < 0.05), the ROM increased significantly (p < 0.05), and there was no significant difference between the two groups (p > 0.05)
Summary
To compare the effect of decompression of the spinal canal with or without discectomy on the clinical efficacy of Dynesys dynamic fixation treatment in lumbar degenerative diseases. All patients underwent decompression of the spinal canal with Dynesys dynamic fixation and were divided into two groups. E intervertebral height, range of motion, Pfirrmann grade of the surgical segment and the upper adjacent segment, function scores, and operation information were compared. E retained percentages of surgical segment intervertebral height and ROM in group A were significantly better than those in group B (p < 0.05). E intervertebral height (p > 0.05) and range of motion (p < 0.05) of the surgical segment in group A were higher than those in group B. e surgical segment Pfirrmann grading of group A was better than that of group B (p < 0.05). In selected cases without discectomy, the range of motion and intervertebral height may be better preserved, and disc degeneration may be reduced
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