The Clinical Comparative Study Between Dynesys Dynamic Internal Fixation And Posterior Lumbar Interbody Fusion In Lumbar Degenerative Disease

Objective:Comparative analysis of Dynesys internal fixation and bone graft fusion and internal fixation (TLIF) two kinds of surgical treatment of lumbar degenerative disease clinical curative effect and difference, for further clinical application.Methods:Analysis of ancient and modern literature theory part, summarizes the scholars of traditional Chinese medicine to the understanding of the etiology and pathogenesis of lumbar degenerative disease and the corresponding diagnosis and treatment methods;Clinical research part of jiangsu province hospital spinal medical teams in Jan 2013 to Jan 2016 treated 34 cases diagnosed as lumbar degenerative disease (L4/5) in patients with clinical data were retrospectively analysis of the Dynesys the treatment of 14 cases of using TLIF operation for 20 cases.Comparing two kinds of internal fixation surgery in perioperative: operation time, blood loss, postoperative hospitalization days, postoperative complications;The ODI, VAS score evaluation of two groups of postoperative follow-up clinical curative effect to improve the situation.By collecting preoperatie and follow-up of the lumbar spine X-ray, measured preoperatively and at the time of the last follow-up surgery and upper and lower segmental intervertebral height and of motion (ROM), assessment of adjacent segment degeneration degree.Results:Two groups of patients in the operation time, blood loss, hospitalization days after treatment, significant comparative difference (P<0.05), Dynesys is better than that of TLIF group;Two groups at the time of the last follow-up Oswestry disability index (ODI) and visual analogue scale (VAS) pain scores were compared with before treatment significantly improved (P<0.05), the comparison between groups have no statistical difference (P> 0.05);Dynesys group of preoperative and postoperative intervertebral disc height has no obvious change during the follow-up period, fusion group of postoperative intervertebral disc height has the obvious rise;Dynesys postoperative some fixed set of segmental mobility,4.12 ±1.89°, postoperative TLIF group activity to 0;Two groups of upper and lower segmental preoperative and postoperative intervertebral height contrast has no difference in the group, two groups of lower intervertebral motion changes no statistical difference, while TILF group have obvious superior segmental mobility rise statistically difference;Follow-up period Dynesys group found no nail loose rope system and polyester casing, TLIF group obtained fusion.Conclusions:Dynesys fusion dynamic internal fixation and fusion and internal fixation (TLIF) recent curative effect in the treatment of lumbar degenerative disease, two treatment procedure;Dynesys surgical operation time is short, small trauma, shorter hospitalization time, has certain minimally invasive advantage;Dynesys dynamic fixation can retain part fixed segment activity for superior segmental motion.