The Observation Of Truma Stress Response And Clinical Outcomes In Treatment Of Dynesys Statibilization System For Lumbar Disc Herniaion

Objective Analyzing the variation of traumatic stress response during acute phase and early-term,middle-term clinical outcomes following Dynesys stabilization in the treatment for lumbar disc herniation. Methods Altogether 52 patients were elected into the study by the criteria between December 2012 and February 2014,and were assigned to Dynesys group(n=25) and transforaminal interbody fusion(TLIF)(TLIF group,n=27).Operative time,blood loss volume during the operation,The serum levels of Interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-α) were tested before and 6 hours,12 hours,24 hours,and C-reactive protein(CRP)were detected before and 1 days,2 days,5days after operation to evaulte the traumatic stress response to the either operations.As well as Oswestry disability index(ODI)and Visual analogue scale(VAS) were recorded before and 3 months,last time after operation. Then comparing the difference of the datas berween the both groups to evaluate surgical stress and clinical outcomes.Results The operative time of Dynesys group was less than that of TLIF group(112.3±20.4min VS.148.8±56.2 min)(P<0.05).The intraoperative hemorrhage of Dynesys group was far less than that of TLIF group(232±63mL VS.405±85mL)(P<0.05).It made no significant differences between the two groups about the preoperative serum levels of IL-6, TNF-α, CRP(P>0.05).By comparing with preoperative levels,the serum concentrations of IL-6 rose in both groups at 6 hours,12 hours,24 hours after surgery(P<0.05).The serum levels of TNF-α only rose in 6 hour in both groups after operation(P<0.05).It made no significant differences in the serum levels of IL-6,TNF-α between the both groups before operation(P>0.05).The serum levels of IL-6 at each time point after surgery in Dynesys group were considerably below those in TLIF group(P<0.05),and there were no statistical differences of TNF-α level at each time point after operation in the both groups(P>0.05).In both groups,the levels of CRP significantly increased at 1 day after operation(P<0.05),but the indice in Dynesys group were significantly below that in TLIF group(P<0.05).ODI and VAS were improved greatly 3 months,last time after operation(P<0.05),but the difference was not significant between the two groups(P>0.05). Conclusion Compared with traditional TLIF,Dynesys has similar clinical outcomes. compared with TLIF,Dynesys gave a rise to less release of serum indices in traumatic stress response,and resulted in less tissue damage and systemic traumatic stress response,which could improve security of surgery.