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Short-term effects of minimally invasive dynamic neutralization system for the treatment of lumbar spinal stenosis: An observational study.

Abstract The aim of the study was to evaluate the safety and short-term effects of dynamic stabilization via minimally invasive system for degenerative lumbar spinal stenosis. Patients with degenerative lumbar spinal stenosis and treated with Transforaminal Lumbar Interbody Fusion via minimally invasive minimally system (mis-TLIF) were served as the control group.From April 2011 to March 2015, 47 patients (29 male, 18 female; mean age 47.6 [range, 26-52] years) with lumbar spinal stenosis were treated with decompression and excision of herniated disk via the minimally invasive system combined with the dynamic fixation technique, and 42 patients as control group with mis-TLIF. Minimally invasive surgeries were performed via the posterior incision approach. The clinical outcomes were evaluated by comparing the Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI) scores, and the ROMs of the adjacent segment before and after surgery. The postoperative complications related to the implants were identified.A total of 83 patients (43 of Dynesys group and 40 of mis-TLIF group) were followed for an average duration of >35 months. Dynesys stabilization resulted in significantly higher preservation of motion at the index level (P < .05), and significantly less hypermobility at the adjacent segments. VAS for the back and leg pain and ODI improved significantly (P < .05) in 2 groups; however, there is no significant difference between the groups. In Dynesys group, 3 cases suffered skin flay necrosis, 1 of them had a wound infection that was treated with washing and drainage combined with antibiotic therapy. Skin flay necrosis were also observed in 2 cases of mis-TLIF group. Reoperation was performed in one case of Dynesys group for rupture of the internal fixation. No rupture of internal fixation was observed in mis-TLIF group.The nonfusion fixation system Dynesys may be used to treat degenerative spinal stenosis without posterior element damage. This surgical technique is safe and effective. However, utilizing higher preservation of motion may lead to the failure of internal fixation.
PMID
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Authors

Mayor MeshTerms

Internal Fixators

Keywords
Journal Title medicine
Publication Year Start




PMID- 29851799
OWN - NLM
STAT- MEDLINE
DCOM- 20180606
LR  - 20180606
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 22
DP  - 2018 Jun
TI  - Short-term effects of minimally invasive dynamic neutralization system for the
      treatment of lumbar spinal stenosis: An observational study.
PG  - e10854
LID - 10.1097/MD.0000000000010854 [doi]
AB  - The aim of the study was to evaluate the safety and short-term effects of dynamic
      stabilization via minimally invasive system for degenerative lumbar spinal
      stenosis. Patients with degenerative lumbar spinal stenosis and treated with
      Transforaminal Lumbar Interbody Fusion via minimally invasive minimally system
      (mis-TLIF) were served as the control group.From April 2011 to March 2015, 47
      patients (29 male, 18 female; mean age 47.6 [range, 26-52] years) with lumbar
      spinal stenosis were treated with decompression and excision of herniated disk
      via the minimally invasive system combined with the dynamic fixation technique,
      and 42 patients as control group with mis-TLIF. Minimally invasive surgeries were
      performed via the posterior incision approach. The clinical outcomes were
      evaluated by comparing the Visual Analog Scale (VAS) score, Oswestry Disability
      Index (ODI) scores, and the ROMs of the adjacent segment before and after
      surgery. The postoperative complications related to the implants were
      identified.A total of 83 patients (43 of Dynesys group and 40 of mis-TLIF group) 
      were followed for an average duration of &gt;35 months. Dynesys stabilization
      resulted in significantly higher preservation of motion at the index level (P &lt;
      .05), and significantly less hypermobility at the adjacent segments. VAS for the 
      back and leg pain and ODI improved significantly (P &lt; .05) in 2 groups; however, 
      there is no significant difference between the groups. In Dynesys group, 3 cases 
      suffered skin flay necrosis, 1 of them had a wound infection that was treated
      with washing and drainage combined with antibiotic therapy. Skin flay necrosis
      were also observed in 2 cases of mis-TLIF group. Reoperation was performed in one
      case of Dynesys group for rupture of the internal fixation. No rupture of
      internal fixation was observed in mis-TLIF group.The nonfusion fixation system
      Dynesys may be used to treat degenerative spinal stenosis without posterior
      element damage. This surgical technique is safe and effective. However, utilizing
      higher preservation of motion may lead to the failure of internal fixation.
FAU - Tu, Ji
AU  - Tu J
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Hua, Wenbin
AU  - Hua W
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Li, Wentian
AU  - Li W
AD  - Wuhan Institute of Biological Products Co., Ltd.
FAU - Liu, Wei
AU  - Liu W
AD  - Department of Orthopaedics, Wuhan No. 1 Hospital, Tongji Medical College,
      Huazhong University of Science and Technology, Wuhan, Hubei Province, China..
FAU - Luo, Rongjin
AU  - Luo R
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Li, Shuai
AU  - Li S
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Zhang, Yukun
AU  - Zhang Y
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Kang, Liang
AU  - Kang L
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Wang, Kun
AU  - Wang K
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Song, Yu
AU  - Song Y
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Yang, Shuahua
AU  - Yang S
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
FAU - Yang, Cao
AU  - Yang C
AD  - Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong
      University of Science and Technology.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Decompression, Surgical/*instrumentation/methods
MH  - Female
MH  - Humans
MH  - *Internal Fixators
MH  - Intervertebral Disc Displacement/complications/physiopathology/surgery
MH  - Lumbar Vertebrae/surgery
MH  - Male
MH  - Middle Aged
MH  - Minimally Invasive Surgical Procedures/instrumentation/methods
MH  - Range of Motion, Articular
MH  - Spinal Fusion/*instrumentation/methods
MH  - Spinal Stenosis/complications/physiopathology/*surgery
MH  - Treatment Outcome
EDAT- 2018/06/01 06:00
MHDA- 2018/06/07 06:00
CRDT- 2018/06/01 06:00
PHST- 2018/06/01 06:00 [entrez]
PHST- 2018/06/01 06:00 [pubmed]
PHST- 2018/06/07 06:00 [medline]
AID - 10.1097/MD.0000000000010854 [doi]
AID - 00005792-201806010-00027 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Jun;97(22):e10854. doi: 10.1097/MD.0000000000010854.