Early Clinical Observation Of Isobar TTL Dynamic Fixation System In The Treatment Of Lumbar Degenerative Diseases

BackgroudLumber degenerative disease is a common and major causes of low back pain,after conservative treatment,the curative effect is not ideal,surgical treatment should be considered. Spinal fusion technology has been developed for more then 1 countries,a large number of clinical studies confirmed the safty and efficacy of it, it was identifyied as the classic surgical treatment of spinal diseases by general surgeon,.But the fution fixed change the biomechanics of normal spine,after spinal fusion,because of stiff spinal fusion segments,to keep the scope of their activities,resulting in the scope of activites of adjacent segment compensateory increases.The adjacent intervertebral disc and facet joint lording increased,leading to the adjacent segment degeration,especially the adjacent intervertebral disc has degerated before the surgery.After the fusion,the adjacent degeration incidence increased significantly.Isobar TTL dynamic system can keep the stable of spine,also maintain the interverbral height and can retain the dynamic fixed segment certain activity,can prevent the degeneration of adjacent segment of the role.Objecttive1.To evaluate the short-term clinical efficacy of Isobar TLL dynamic stabilization system in the treatment of lumbar degenerative disease.2.To preliminary investigate the protective effect of Isobar TTL dynamic fixation system on the adjacent segments.Method2013 March to 2014 December in department of orthopedics of Dongzhimen hospital by Isobar TTL semi rigid fixation and single section dynamic non fusion in treatment of lumbar degenerative disease in 30 cases, postoperative 7d after lumbar X scan, patients have their re-gular clinical follow-up, extension radiographs by lateral lumbar spineflexion, the measureme nt of dynamic fixed section period of activity, intervertebral height index, the UCLA evaluat-ion of intervertebral disc degeneration; VAS visual analogue score, ODI disability index, the last follow-up according to the evaluation of curative effect of the improved Macnabstandard evaluation of patients with total curative effect.Resultspatiennts were successfully completed operation, and followed up(6month-18month), the average follow-up time lOmonth.The postoperative followed up time point,VAS score and score and ODI score were significantly decreased,the difference was statistically significant. At the last follow-up evaluation of clinical curative effect to the modified MacNab criteria, the results were excellent in 20 cases, good in 8 cases,2 cases, bad in 0 case, the excellent and good rate was 93.33%, at the time of the last follow-up, all patients were not foundin internal fixation, fracture and other complications.Follow up ROM dynamic fixation segments were significanty decreased compared with preoperative, the difference was statistically significant (p<0.01), the dynamic fixation segments of ISR were compared with the preoperative, had a little decreased at the end of the follow-up time to the preoperative level. Compared with preoperative had no statistical significance (p>0.05), Adjacent segment degeneration without apparent progress.