The Effects Of The Combination Of Unilateral Pedicle Screw Fixation And Cage Bone Graft Fusion On The Fusion Segment Of Contralateral Facet Joints

Objective Explore the effects of the combination of unilateral pedicle screw fixation and Cage bone graft fusion on the configuration of the fusion segment of contralateral facet joints.Method To retrospectively research on clinical data of 30 patients,who were admited between December 2012 and December 2013 by the spine surgery,have been collected.And those cases had already been taken the combination treatment of unilatertal pedicle screw fixation and cage lumbar intervertebral fusion on the L4/L5 segment.In order to measur the angle of contralateral facet joints and the transverse diameter distance of facet joints of L4/L5 segment surgery, CT measurement software has been applied parallel on the L5 vertebral endplate level.After measurement,the preoperative and postoperative CT datas of patients have been made a comparison and then analyzed with statistical software.Meanwhile,the criteriawhich setted by the Japanese Orthopaedic Association(JOA) and the visual analogue scale(VAS) have been used to evaluate whether the lumbosacral pain of patients had significantly decreased or not and the postoperative curative effect.Result 1.Before treatment,the angle of facet joint was(42.61±5.75) degree,and turned into(42.85±5.394) degree after treatment.There is no significant difference between the preoperative angle of facet joints and the postoperative one(P>0.05). 2.Before treatment,the transverse diameter of facet joint was(15.60±1.01) mm,and turned into(15.89±1.48)mm after treatment. There is no significant difference between the preoperative transverse diameter of facet joints and the postoperative one(P>0.05). 3.Results of VAS(visual analogue scale):The preoperative VAS score was(5.26±1.02),and after treatment for 1 week,6 monthes and 12 monthes the VAS score turned into(1.85±0.26),(1.6±0.23) and(0.85±0.08).The postoperative VAS score is significantly lower than before(P<0.05). 4.Resuls of JOA score:The preoperative JOA score was(10.47±1.36),and after treatment for 1 week,6 monthes and 12 monthes the JOA score turned into(21.77±1.55),(23.58±1.58) and(23.46±1.80).The postoperative JOA score is significantly higher than before(P<0.05).Conclusion 1.The combination of unilateral pedicle screw fixation and Cage intervertebral fusion has no significant effects on the angle and the transverse diameter of the fusion segment of contralateral facet joints. 2.The configuration changes of facet joints which caused by the combination of unilateral pedicle screw fixation and Cage intervertebral fusion has no clear correlation with the lumbosacral pain. 3.The combination treatment of unilateral pedicle screw fixation and Cage interbertebral fusion is an economical and effective clinical treatment for lumbar degenerative disease.