A Clinical Controlled Study Of Dynesys Dynamic Stabilization And Posterior Lumbar Interbody Fusion In The Treatment Of Lumbar Spine Degenerative Diseases

ObjectiveTo analyze the efficacy of Dynesys dynamic stabilization and PLIF in the treatment of L 4/5 single-segment lumbar disc herniation and lumbar spinal stenosis.MethodsCollecting 30 cases of L4/5 single-segment lumbar disc herniation and lumbar spinal sten osis caused by lumbar degeneration in our hospital from January 2014 to December 2016.A ccording to different surgical methods,they were divided into Dynesys dynamic stabilization gr oup)(Dynesys group),15 cases)and lumbar posterior decompression fusion group(PLIF group,15 cases).The age,duration of disease,operation time,intraoperative blood loss,and length of hospital stay were compared between the two groups.All patients were followed up(24-28 months).The follow-up data were analyzed by VAS score,JOA score and ODI index.The preoperative and final follow-up X-ray examination data of the two groups were analyzed.Measuring adjacent segment L34 gap height(H),L3-4 intervertebral activity(ROM),The U CLA(University of California at Los Angeles Grading Scale)vertebral space degeneration gra ding standard was used to observe the degeneration of adjacent segments.Comparative analysi s of Dynesys elastic fixation and PLIF surgery can delay or accelerate the development of A SD.Results1.The average follow-up of the Dynesys group was(26.93 ± 2.46)months,and the mean follow-up of the PLIF group(28.27±2.86)months.2.There were significant differences in the operation time and intraoperative blood loss between the two groups(P<0.01).There was no significant difference in age,duration of disease and hospitalization between the two groups(P>0.05).3.VAS score,JOA score and ODI of the Dynesys group and PLIF group were significantly changed before preoperative and final follow-up(P<0.01),There were no significant differences between the two groups before and final follow-up(P>0.05).4.The Dynesys group had statistically difference between preoperative and follow-up time L3-4 intervertebral space heightand L3-4 intervertebral ROM(P<0.05).The PLIF group had statistically significant difference between preoperative and follow-up time L3-4 intervertebral space height and L3-4 intervertebral ROM(P0.01).Dynesys group and PLIF group were no significant differences before and after the follow-up(P>0.05).5.There was a statistically difference between preoperative and follow-up time L3-4 UCLA score in two groups.There were no significant differences between the two groups before and after the follow-up)(P>0.05).ConclusionDynesys dynamic stabilization and PLIF achieve good postoperative results in the treatment of lumbar degenerative diseases.Both Dynesys dynamic stabilization and PLIF can show the loss of vertebral height and the increase of intervertebral activity in adjacent segments,Dynesys ela stic fixation is slower in the loss of adjacent segmental vertebral body height and lumbar spine ROM activity.And the operation time is short and the amount of intraoperative blood loss is small.It shows that Dynesys elastic fixation is a safe and effective surgical procedure that can delay the occurrence of ASD.