[Effectiveness of discectomy combined with Isobar non-fusion internal fixation in treating lumbar disc protrusion].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Feb; 25(2):229-34.ZX
To evaluate the short-term results of discectomy combined with Isobar non-fusion internal fixation.
Between May 2006 and May 2008, 65 cases of single segment lumbar disc protrusion were random surgically treated by discectomy combined with Isobar non-fusion internal fixation (34 cases, group A) and single discectomy (31 cases, group B), respectively. In group A, there were 18 males and 16 females with an average age of 38.8 years (range, 23-51 years); the involved segments were L(2,3) (1 case), L(3,4) (4 cases), L(4,5) (20 cases), and L5, S1 (9 cases), including 11 cases of protrusion type, 16 cases of prolapsed-type, and 7 cases of sequestered type; and the mean disease duration was 7.2 months (range, 1-66 months). In group B, there were 19 males and 12 females with an average age of 39.2 years (range, 21-49 years); the involved segments were L(3,4) (2 cases), L(4,5) (24 cases), and L5, S1 (5 cases), including 13 cases of protrusion type, 15 cases of prolapsed-type, and 3 cases of sequestered type; and the mean disease duration was 6.5 months (range, 3 weeks to 72 months). There was no significant difference in the general data between 2 groups (P > 0.05). The surgical results were assessed by visual analogue scale (VAS) for back/leg pain and the Oswestry disability index (ODI). The height of involved intervertebral space was measured dynamically after operation.
The patients of two groups were followed up 32 months on average (range, 24-49 months). All clinical symptoms of the patients were notably improved in 2 groups. One patient in group B experienced postoperative cerebral fluid leakage, and was cured after extubation, changing posture, and other measures. There was no implant failure, such as pedicle fracture, screw loosening, or screw malposition during the follow-up. The ODI and VAS were significantly improved after operation. The back and leg pain VAS scores at each time point were decreased significantly when compared with those before operation (P < 0.05) in 2 groups. There were significant differences in back pain VAS (P < 0.05) between groups A and B at 1 and 2 years after operation. There was significant difference in the ODI score (P < 0.05) at 2 years when compared with that before operation in 2 groups, but there was no significant difference between 2 groups (P > 0.05). After operation, the mean height of involved intervertebral space was increased significantly (P < 0.05) when compared with preoperative value in group A, while the height had a gradual decline at 3 weeks and 3 months (P > 0.05), and had a significant decline at 6 months, 1 year, and 2 years (P < 0.05) when compared with preoperative value in group B. There were significant differences in the height of involved intervertebral space between groups A and B at each time point after operation (P < 0.05).
Discectomy combined with Isobar non-fusion internal fixation presents with satisfactory short-term results; moreover, it can better relieve back pain in comparison with single discectomy, which possibly related to the preservation of responsible intervertebral spaces.