Clinical efficacy and radiographic K-Rod stabilization for the treatment of multilevel degenerative lumbar spinal stenosis
| Autor: | Tianjun Chen, Maohui Diao, Hongsheng Lin, Zhisheng Ji, Chao-Hua Fu, Guowei Zhang, Hua Yang, Yuhao Yang |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty lcsh:Diseases of the musculoskeletal system Sports medicine genetic structures Multisegmental degenerative lumbar spinal stenosis Radiography Intervertebral Disc Degeneration Dynamic stabilization system 03 medical and health sciences 0302 clinical medicine Spinal Stenosis Rheumatology Internal medicine medicine Humans Orthopedics and Sports Medicine Clinical efficacy Range of Motion Articular Aged Retrospective Studies Degenerative lumbar spinal stenosis Lumbar Vertebrae business.industry Intervertebral disc Middle Aged medicine.anatomical_structure Spinal Fusion Treatment Outcome 030220 oncology & carcinogenesis Orthopedic surgery Lordosis Selective fusion Female K-rod Spondylolisthesis lcsh:RC925-935 business Nuclear medicine Lumbar lordosis 030217 neurology & neurosurgery Research Article |
| Zdroj: | BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-8 (2020) BMC Musculoskeletal Disorders |
| Popis: | Background This study compares the use of radiographic K-Rod dynamic stabilization to the rigid system for the treatment of multisegmental degenerative lumbar spinal stenosis (MDLSS). Methods A total of 40 patients with MDLSS who underwent surgical treatment using the K-Rod (n = 25) and rigid systems (n = 15) from March 2013 to March 2017 were assessed. The mean follow-up period was 29.1 months. JOA, ODI, VAS and modified Macnab were assessed. Radiographic evaluations included lumbar lordosis angle, ISR value, operative and proximal adjacent ROM. Changes in intervertebral disc signal were classified according to Pfirrmann grade and UCLA system. Results JOA, ODI and VAS changed significantly after the operation to comparable levels between the groups. However, the lumbar lordosis significantly decreased at final follow-up between both groups. The ROM of the proximal adjacent segment increased at final follow-up, but the number of fixed segment ROMs in the K-Rod group were significantly lower at the final follow-up than observed prior to the operation. In both groups, the ISR of the proximal adjacent segment decreased, most notably in the rigid group. The ISR of the non-fusion fixed segments in the K-Rod group increased post-operation and during final follow-up. The levels of adjacent segment degeneration were higher in the rigid group vs. the K-Rod group according to modified Pfirrmann grading and the UCLA system. Conclusions Compared with the rigid system for treatment of MDLSS, dynamic K-Rod stabilization achieves improved radiographic outcomes and improves the mobility of the stabilized segments, minimizing the influence on the proximal adjacent segment. |
| Databáze: | OpenAIRE |
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