The Early Clinical Observation About Dynesys And Lumbar Interbody Fusion In Treatment Of Lumbar Vertebra Cataplasia Diseases

Objective: To invetigate the difference of early clinical efficacy between Dynesys andlumbar interbody fusion in treatment of lumbar vertebra cataplasia diseases. Contrastthe difference between the two, with a view to finding a better method of operationMethods Clinical datas of36patients under two methods treatment lumbar vertebracataplasia disease each18examples were retrospevtively analyzed,10males and26females, aged35to71years, duration of9months to10years. Admissions order toinform patients and randomized consent, the same proportion of patients were men andwomen, similar to the prevalence and the average age difference of not more thanfive-year-old general was no significant difference (P>0.05). Two groups of patientswith lumbar spinal stenosis and lumbar intervertebral disc herniation are7cases in each,patients with lumbar instability and lumbar intervertebral disc herniation are6cases ineach, patients with lumbar intervertebral disc herniation are5cases in each. Dynesysgroup of are18patients,5males and13females, aged35to71years, mean46.1±14.2years. Course is9months to8years, an average of37.4±50.6months. Lumbar fusiongroup are18patients,5males and13females; aged38to68years, mean43.6±17.1years. Course is1year to10years, an average of46.9±48.7months. Postoperativeconventional negative pressure drainage continue48~72h, symptomatic treatment andrehabilitation training with patients. The postoperative examination has been taken andpostero-anterior radio-grammphs, lateral projection radiogrammphs and flexion-extension radiographs were taken at the final follow-up. patients were observedblood loss, VAS score, ODI index, the rate for short-term excellent or good relief ofsymptoms and ROM．SPSS17.0statistical software is used to analyze the VAS, ODI andROM,using using two sample rank sum test (Wilcoxon) in goup, using two independentsamples rank sum test (Mann-Whitney U) between two goups and using Wilcoxon ranksum test in the excellent rate of surgical results.Results Surgery patients were performed smoothly, and vital signs smoothly, nopreoperative and postoperative complications. The timing of the operation: Dynesysgroup is in the range of91~123min and average108±15min，lumbar fusion group isin the range of112~155min and average136±23min, two groups of comparisonsdifference was not statistically significant (P <0.05). In Dynesys group theintraoperative blood loss was100~300ml and average152±80ml, the lumbar fusiongroup intraoperative blood loss was200~500ml and average361±120ml, twogroups of comparisons difference was statistically significant (P <0.01). The effect wasevaluated with Nakai standard, and it was excellent in14cases, good in3, fair in1andpoor in0in Dynesys group, compared excellent in13cases, good in3, fair in2andpoor in0in lumbar interbody fusion group. All36patients were followed up for7~33months with an average of22months by the last follow-up as an evaluation criterion.All patients during follow-up were not found serious degeneration phenomenon such asvertebral stenosis and vertebral slip in the operation stage and adjacent segments, nopedicle screw loosening and fracture, flexion extension radiographs showed noinstability of lumbar spine. X-ray films of Dynesys group showed no obviousdegeneration, close to natural degeneration; group X-ray films showed all patientsbone grafting fusion was good without pseudarthrosis performance, but degenerationwas significantly with an accelerating trend. Two groups of VAS and ODI have beensignificantly improved; Dynesys group adjacent segmentes ROM have maintained itsoriginal condition, instrumented segmentes ROM have decreased; Lumbar interbody fusion group adjacent segmentes ROM increases, instrumented segmentes have beenfused. Dynesys group, postoperative VAS was improved to2.21±1.04, ODI wasimproved to18.15±7.28,adjacent segmentes ROM was preserved to preoperativestate,instrumented segmentes ROM was decreased to3.74±0.77°; Lumbar interbodyfusion, postoperative VAS was improved to2.17±1.16, ODI was improved to16.67±9.33, adjacent segmentes ROM were increased, instrumented segmentes were fused.Theimplant state of two groups were well.Conclusion Dynesys and the lumbar interbody fusion can all take the ideal earlycurative effect.Dynesys preserve partial ROM,and prevent accelerated degeneration, isa desirable method of treatment.