Influence Of ISOBAR TTL Dynamic Internal Fixation System On Adjacent Segment Degeneration By MRI Measurement Of Lumbar Nucleus Pulposus Volume

Objective:To investigate the influence of ISOBAR TTL dynamic internal fixation system on degeneration of adjacent intervertebral disc by MRI measurement of lumbar nucleus pulposus volume in treating lumbar degenerative disease after operation.Methods:Between March 2010 and October 2011,34 patients with lumbar intervertebral disc herniation(23 cases of paracentral type and 11 cases of lateral type)underwent operation with ISOBAR TTL dynamic internal fixation system for fixation of single segment,and the clinical data were analyzed retrospectively.There were 20 males and 14 females,aged 39-62 years(mean,47.5 years).The disease duration was 6-18 months(mean,14 months).Involved segments included L4?5 in 21 cases and L5,S1 in 13 cases.The X-ray films and MRI images were taken at 6,12,18,24,36,and 48 months after surgery.Based on X-ray films,the height of intervertebral space was measured using angle bisectrix method.The nucleus pulposus volume was measured based on the MRI scan.The postoperative change of nucleus pulposus volume and intervertebral disc height were used to evaluate the influence of ISOBAR TTL system on degeneration of adjacent intervertebral disc nucleus pulposus.Results:Thirty patients were followed up 48 months.The height of intervertebral space showed no significant difference between at pre-and post-operation(P>0.05).The nucleus pulposus volume increased after operation,showing no significant difference at 6,12,and 18 months when compared with preoperative value(P>0.05),but significant difference was found at 24,36,and 48 months when compared with preoperative value(P<0.05).The height of nucleus pulposus increased after operation but the width was decreased;the values showed no significant difference at 6,12,and 18 months when compared with preoperative ones,but showed significant difference at 24,36,and 48 months when compared with preoperative ones(P<0.05).The diameter of nucleus pulposus at 18,24,36,and 48 months after operation was significantly langer than that at preoperation(P<0.05).Conclusion: ISOBAR TTL dynamic internal fixation system can prevent or delay the degeneration of intervertebral discs.