Comparative Study Of Treating Lumber Disc Herniation By Unilateral Cosmic Dynamic Stabilization And Unilateral Pedicle Screw Fixation

1. Purpose of researchTo compare the clinical outcome and effects of the unilateral Cosmic dynamic stabilization and the unilateral pedicle screw fixation on lumbar disc herniation.2.Methods:From January 2010 to September 2012 on 36 cases of lumbar disc herniation(L5S1) patients by nucleus pulposus removal of cosmic unilateral non fusion internal fixation(18 cases) and nucleus pulposus removal unilateral fusion and internal fixation(18 cases) were treated surgically; non fusion group(18 cases), 8 cases were male, 10 female patients, age 40-59 years old, with an average age of49years; fusion group 18 cases, 11 cases were male. Males and 7 females, age37-60 years old, with an average age of48.5. All patients underwent lumbar lateral and flexion X-ray, lumbar CT and lumbar MRI scan before operation. Total nephrectomy was performed on 36 cases, postoperative follow-up, 36 cases were followed up, the cosmic unilateral fixed non fusion groups were followed up for 12 to 25 months, the average follow-up time was 19.5 months and unilateral internal fixation and fusion patients were followed up for 12 to 26 months, average follow-up time was20.5months. Record the operation time of the two groups in the period, the amount of bleeding, were evaluated in patients with preoperative and postoperative follow-up pain visual simulation score(visual analogue scale, VAS), Oswestry disability index(ODI) score, and statistical analysis compared; in lumbar dynamic X-ray sheet were measured and recorded in patients with preoperative and postoperative at the end of the follow-up activities of operative segment(L5/S1), adjacent segment(L4,5) and lumbar(L1/s1) degrees(range of motion, Rom), and were statistically analyzed and compared.3.Results:All patients were healed by incision I stage after operation. There were no complications such as nerve root injury, infection, cerebrospinal fluid leakage, disc herniation recurrence, fusion device translocation and loosening of internal fixation implant and other complications during the end of the two groups..The operation time and intraoperative blood loss were statistically analyzed and compared(see Table 1), non fusion group and fusion group, the mean operation time was respectively72±3.1min and98.0±2.9min, operation in the average amount of bleeding respectively 131.0±8.0ml and 166.0±8.1ml, and two compares the differences were statistically meter significance(P < 0.01), namely the fusion group, operation time and intraoperative blood loss were higher than those of non fusion group(P < 0.01).Of two groups of patients with preoperative and postoperative(at last follow-up vas and ODI scores were statistically compared(see Table 2), non fusion group before operation and at the end of the VAS score were 7.0±1.5 points and 2.8±1.1points, before operation and the last follow-up ODI scores were 44.0±5.4points and18.1±5.0 points; fusion group before operation and at the end of the VAS score was 8.0±1.5 and3.0±1.8 points, before surgery and at the end of the follow-up ODI score respectively 46.0±6.2 points and 19.1 ± 4.9 points good. Longitudinal comparison of preoperative and postoperative last follow-up VAS score and ODI score, the difference between the two groups were statistically significant(P < 0.01), two groups of patients with postoperative ODI and VAS score compared with the preoperative were improved significantly. The VAS score and ODI score of the non fusion group and the fusion group were compared with the non fusion group, and the difference was not statistically significant(P > 0.05). That is, according to VAS score and ODI score to evaluate the effect of treatment, the two groups in the treatment of lumbar disc herniation have a significant effect, while the treatment effect between the two no obvious difference.4.Conclusion:The two surgical methods can achieve satisfactory results in the treatment of lumbar disc herniation.. Nucleus pulposus removal of cosmic unilateral non fusion and internal fixation with nucleus pulposus removal of unilateral fusion and internal fixation compared, consumption of short operation time, bleeding, lower than the latter and the postoperative segmental and lumbar destruction lighter.