EFFECTIVENESS OF ISOBAR TTL SEMI-RIGID DYNAMIC STABILIZATION SYSTEM IN TREATMENT OF LUMBAR DEGENERATIVE DISEASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Li ¹ , SHU Xiaoqiu ¹ , DUAN Yang ¹ , YE Gang ² , JIN Anmin ¹

1Department of Orthopaedics, 2Department of Radiology, Zhujiang Hospital, Nanfang Medical University, Guangzhou Guangdong, 510282, P.R.China. Corresponding author: SHU Xiaoqiu, E-mail: shuxiaoqiu63@163.com;

Corresponding author：

Keywords：

Lumbar degenerative disease Semi-rigid dynamic stabilization system Non fusion

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ObjectiveTo investigate the short-term effectiveness of ISOBAR TTL semi-rigid dynamic stabilization system (ISOBAR TTL system) in treatment of lumbar degenerative disease. MethodsBetween June 2007 and May 2011, 38 cases of lumbar degenerative disease were treated, including 24 males and 14 females with an average age of 51.2 years (range, 21-67 years). The disease duration was 8 months to 10 years (mean, 4.7 years). In 38 cases, there were 4 cases of grade I spondylolisthesis, 11 cases of lumbar instability and lumbar disc protrusion, 21 cases of lumbar spinal stenosis and lumbar disc protrusion, and 2 cases of postoperative recurrence of lumbar disc protrusion. There were 22 cases of adjacent segment disc degeneration. All cases underwent posterior decompression and implantation of ISOBAR TTL system. The double-segment-fixed patients underwent interbody fusion. Visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores for low back pain were used to evaluate clinical outcomes. The range of motion (ROM) at the semi-rigid dynamic stabilization segment was also measured. ResultsThe other cases achieved healing of incision by first intention, except 1 case of delayed healing. All the patients were followed up 8-53 months (mean, 27.8 months). After operation, ISOBAR TTL system showed reliable fixation, and no loosening, breakage, or kyphosis deformity occurred. No adjacent segment degeneration was observed. The ROM of the fixed segments was 0-1° in 3 cases, 1-2° in 4 cases, 2-3° in 14 cases, 3-4° in 15 cases, and gt; 4° in 2 cases. At last follow-up, the VAS score was 1.93 ± 2.43, and was significantly lower than preoperative score (8.20 ± 1.78) (t=7.761, P=0.000). JOA score was 23.06 ± 7.75, and was significantly higher than preoperative score (4.87 ± 3.44) (t=10.045, P=0.000). According to Stauffer-Coventry evaluation standard, the results were excellent in 32 cases, good in 3 cases, fair in 2 cases, and poor in 1 case, with an excellent and good rate of 92.1%. ConclusionGood short-term effectiveness can be achieved by surgical intervention with ISOBAR TTL system in treatment of lumbar degenerative disease.

Citation： ZHANG Li,SHU Xiaoqiu,DUAN Yang,YE Gang,JIN Anmin. EFFECTIVENESS OF ISOBAR TTL SEMI-RIGID DYNAMIC STABILIZATION SYSTEM IN TREATMENT OF LUMBAR DEGENERATIVE DISEASE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(9): 1066-1070. doi: Copy

1.	管俊杰, 石志才. 腰椎动态固定技术的临床研究进展. 脊柱外科杂志, 2010, 8(1): 59-62.
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13.	郑晓勇, 侯树勋, 李利. 腰椎融合术后相邻节段的退变与临床疗效的关系. 中国矫形外科杂志, 2009, 17(23): 1782-1785.
14.	章筛林, 石志才. 腰椎非融合置入物及其置入技术. 中国组织工程研究与临床康复, 2008, 12(17): 3333-3336.
15.	朱悦, 崔显峰. 腰椎后方动态固定的临床应用. 中国修复重建外科杂志, 2007 , 21(10): 1099-1103.
16.	Lawhorne TW 3rd, Girardi FP, Mina CA, et al. Treatment of degenerative spondylolisthesis potential impact of dynamic stabilization based on imaging analysis. Eur Spine J, 2009, 18(6): 815-822.
17.	李新炜. 非融合技术在腰椎退行性疾病中的临床应用. 医学综述, 2011, 17(23): 3578-3581.
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20.	李伟, 杨庆国. 腰椎后路非融合固定系统的临床应用进展. 临床骨科杂志, 2009, 12(5): 578-581.

1. 管俊杰, 石志才. 腰椎动态固定技术的临床研究进展. 脊柱外科杂志, 2010, 8(1): 59-62.
2. Bothmann M, Kast E, Boldt GJ, et al. Dynesys fixation for lumbar spine degeneration. Neurosurg Rev, 2008, 31(2): 189-196.
3. Kumar MN, Jacquot F, Hall H. Long term follow-up of functional outcomes and radiographic changes at adjacent levels following lumbar spine fusion for degenerative disc disease. Eur Spine J, 2001, 10(4): 309-313.
4. Di Silvestre M, Lolli F, Bakaloudis G, et al. Dynamic stabilization for degenerative lumbar scoliosis in elderly patients. Spine (Phila Pa 1976), 2010, 35(2): 227-234.
5. Schaeren S, Broger I, Jeanneret B. Minimum four-year follow-up of spinal stenosis with degenerative spondylolisthesis treated with decompression and dynamic stabilization. Spine (Phila Pa 1976), 2008, 33(18): E636-642.
6. Cakir B, Carazzo C, Schmidt R, et al. Adjacent segment mobility after rigid and semirigid instrumentation of the lumbar spine. Spine (Phila Pa 1976), 2009, 34(12): 1287-1291.
7. Schulte TL, Hurschler C, Haversath M, et al. The effect of dynamic semi rigid implants on the range of motion of lumbar motion segments after decompression. Eur Spine J, 2008, 17(8): 1057-1065.
8. Stauffer RN, Coventry MB. Anterior interbody lumbar spine fusion: analysis of Mayo clinic series. J Bone Joint Surg (Am), 2002, 54(4): 756-758.
9. Lee CK. Accelerated degeneration of the segment adjacent to a lumbar fusion. Spine (Phila Pa 1976), 1988, 13(3): 375-377.
10. Gillet P. The fate of the adjacent motion segments after lumbar fusion. J Spinal Disord Tech, 2003, 16(4): 338-345.
11. Kumar MN, Baklanov A, Chopin D. Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J, 2001, 10(4): 314-319.
12. Park P, Garton HJ, Gala VC, et al. Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine (Phila Pa 1976), 2004, 29(17): 1938-1944.
13. 郑晓勇, 侯树勋, 李利. 腰椎融合术后相邻节段的退变与临床疗效的关系. 中国矫形外科杂志, 2009, 17(23): 1782-1785.
14. 章筛林, 石志才. 腰椎非融合置入物及其置入技术. 中国组织工程研究与临床康复, 2008, 12(17): 3333-3336.
15. 朱悦, 崔显峰. 腰椎后方动态固定的临床应用. 中国修复重建外科杂志, 2007 , 21(10): 1099-1103.
16. Lawhorne TW 3rd, Girardi FP, Mina CA, et al. Treatment of degenerative spondylolisthesis potential impact of dynamic stabilization based on imaging analysis. Eur Spine J, 2009, 18(6): 815-822.
17. 李新炜. 非融合技术在腰椎退行性疾病中的临床应用. 医学综述, 2011, 17(23): 3578-3581.
18. Perrin G, Cristini A. Prevention of adjacent level degeneration above a fused vertebral segment: Long term effect, after a mean follow-up of 8. 27 years, of the semi-rigid intervertebral fixation as a protective technique for pathological adjacent disc. [s.n]: IMAST, 2003.
19. Stoll TM, Dubois G, Schwarzenbach O. The dynamic neutralization system for the spine a multi center study of a novel non-fusion system. Eur Spine J, 2002, 11 Suppl 2: S170-178.
20. 李伟, 杨庆国. 腰椎后路非融合固定系统的临床应用进展. 临床骨科杂志, 2009, 12(5): 578-581.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF ISOBAR TTL SEMI-RIGID DYNAMIC STABILIZATION SYSTEM IN TREATMENT OF LUMBAR DEGENERATIVE DISEASE

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