Clinical Study of Elastic Fixation for Lumbar Intervertebral Fusion_West China Medical Journal

Authors：

 WEIJiang-bo ^1,2 ,  SONGYue-ming ¹ , LIULi-min ¹ , ZHOUChun-guang ¹ , YANGXi ¹

1. Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Orthopedics, Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi 530200, P. R. China;

Corresponding?author：

SONGYue-ming, Email: sym_cd@aliyun.com

Keywords：

Elastic fixation; Lumbar intervertebral fusion; Degenerative lumbar disease; Clinical study

DOI：

10.7507/1002-0179.20150248

Video：

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Objective To assess the feasibility and clinical value of lumbar elastic fixation through the clinical research of elastic fixation for lumbar intervertebral fusion. Methods According to the criteria, we selected 12 patients with lumbar degenerative disease diagnosed between September 2011 and March 2013 as our study subjects. Among them, 8 were females, and 4 were males, aged between 40 and 62 years old, averaging 52.9 years. Elastic fixation was adopted in the lumbar fusion. Evaluation indicators included visual analogue scale (VAS) scores, Oswestry disability index (ODI) score and its rate of improvement, intervertebral height changes, the rate of intervertebral fusion, intervertebral bone callus formation, patient satisfaction and clinical success rate. Results All patients were followed up. During various postoperative follow-up points, VAS score and ODI score improved significantly (P<0.05). A large amount of callus formation was shown in lumbar CT. No fracture, loosened or shifted internal fixation occurred. Conclusion Elastic fixation for lumbar intervertebral fusion provides another choice for the treatment of lumbar degenerative disease.

Citation： WEIJiang-bo, SONGYue-ming, LIULi-min, ZHOUChun-guang, YANGXi. Clinical Study of Elastic Fixation for Lumbar Intervertebral Fusion. West China Medical Journal, 2015, 30(5): 859-864. doi: 10.7507/1002-0179.20150248 Copy

1.	Chrastil J, Patel AA. Complications associated with posterior and transforaminal lumbar interbody fusion[J]. J Am Acad Orthop Surg, 2012, 20(5):283-291.
2.	Deyo RA, Martin BI, Kreuter W, et al. Revision surgery following operations for lumbar stenosis[J]. J Bone Joint Surg Am, 2011, 93(21):1979-1986.
3.	Yu SW, Yen CY, Wu CH, et al. Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years[J]. Arch Orthop Trauma Surg, 2012, 132(5):583-589.
4.	Zagra A, Minoia L, Archetti M, et al. Prospective study of a new dynamic stabilisation system in the treatment of degenerative discopathy and instability of the lumbar spine[J]. Eur Spine J, 2012, 21(Suppl 1):S83-S89.
5.	Kim KA, McDonald M, Pik JH, et al. Dynamic intraspinous spacer technology for posterior stabilization:case-control study on the safety, sagittal angulation, and pain outcome at 1-year follow-up evaluation[J]. Neurosurg Focus, 2007, 22(1):E7.
6.	McDowell I, Newell C. Measuring health:a guide to rating scales and questionnaires[M]. 2nd ed. New York:Oxford University Press, Inc., 1996:446-456.
7.	Fairbank JC, Pynsent PB. The Oswestry Disability Index[J]. Spine (Phila Pa 1976), 2000, 25(22):2940-2952.
8.	Fritz JM, Irrgang JJ. A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale[J]. Phys Ther, 2001, 81(2):776-788.
9.	Pekkanen L, Kautiainen H, Ylinen J, et al. Reliability and validity study of the Finnish version 2.0 of the oswestry disability index[J]. Spine (Phila Pa 1976), 2011, 36(4):332-338.
10.	Blumenthal S, Mcafee PC, Guyer RD, et al. A prospective, randomized, multicenter Food and Drug Administration investigational device exemptions study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion:partⅠ:evaluation of clinical outcomes[J]. Spine (Phila Pa 1976), 2005, 30(14):1565-1575; discussion E387-E391.
11.	Geisler FH, Blumenthal S, Guyer RD, et al. Neurological complications of lumbar artificial disc replacement and comparison of clinical results with those related to lumbar arthrodesis in the literature:results of a multicenter, prospective, randomized investigational device exemption study of Charité intervertebral disc. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004[J]. J Neurosurg Spine, 2004, 1(2):143-154.
12.	Zigler J, Delamarter R, Spivak JM, et al. Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease[J]. Spine(Phila Pa 1976), 2007, 32(11):1155-1162.
13.	Fritzell P, H?gg O, Wessberg P, et al. 2001 Volvo Award Winner in Clinical Studies:lumbar fusion versus nonsurgical treatment for chronic low back pain:a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group[J]. Spine(Phila Pa 1976), 2001, 26(23):2532-2534.
14.	Lee C, Dorcil J, Radomisli TE. Nonunion of the spine:a review[J]. Clin Orthop Relat Res, 2004(419):71-75.
15.	Gornet MF, Burkus JK, Dryer RF, et al. Lumbar disc arthroplasty with Maverick disc versus stand-alone interbody fusion:a prospective, randomized, controlled, multicenter investigational device exemption trial[J]. Spine (Phila Pa 1976), 2011, 36(25):E1600-E1611.
16.	Brantigan JW, Steffee AD, Lewis ML, et al. Lumbar interbody fusion using the Brantigan I/F cage for posterior lumbar interbody fusion and the variable pedicle screw placement system:two-year results from a Food and Drug Administration investigational device exemption clinical trial[J]. Spine (Phila Pa 1976), 2000, 25(11):1437-1446.
17.	Burkus JK. Intervertebral fixation:clinical results with anterior cages[J]. Orthop Clin North Am, 2002, 33(2):349-357.
18.	Duffield RC, Carson WL, Chen LY, et al. Longitudinal element size effect on load sharing, internal loads, and fatigue life of tri-level spinal implant constructs[J]. Spine (Phila Pa 1976), 1993, 18(12):1695-1703.
19.	Templier A, Denninger L, Mazel C, et al. Comparison between two different concepts of lumbar posterior osteosynthesis implants A finite-element analysis[J]. Eur J Orthop Surg Traumatol, 1998, 8(1):27-36.
20.	Goel VK, Gilbertson LG. Basic science of spinal instrumentation[J]. Clin Orthop Rel, 1997, 335:10-31.
21.	Wolff J. The Law of Bone Remodeling[M]. Berlin Heidelberg New York:Springer, 1986.
22.	Frost HM. A 2003 update of bone physiology and Wolff's Law for clinicians[J]. Angle Orthod, 2004, 74(1):3-15.
23.	Champain S, Mazel C, Mitulescu A, et al. Quantitative analysis in outcome assessment of instrumented lumbosacral arthrodesis[J]. Eur Spine J, 2007, 16(8):1241-1249.
24.	Wendsche P. "Dynamic fusion" in lumbar spine degenerative disorders Mid-term results[J]. ArgoSpine News J, 2010, 22(2):67-70.
25.	Barrey CY. Dynamic instrumentation for fusion with Isobar TTL^TM:biomechanical and clinical aspects[J]. ArgoSpine News J, 2010, 22(2):62-66.
26.	Jacobs WC, Van Der Gaag NA, Kruyt MC, et al. Total disc replacement for chronic discogenic low back pain:a Cochrane review[J]. Spine (Phila Pa 1976), 2013, 38(1):24-36.
27.	Park CK, Ryu KS, Lee KY, et al. Clinical outcome of lumbar total disc replacement using ProDisc-L in degenerative disc disease:minimum 5-year follow-up results at a single institute[J]. Spine (Phila Pa 1976), 2012, 37(8):672-677.
28.	Schimmel JJ, Poeschmann MS, Horsting PP, et al. PEEK cages in lumbar fusion:mid-term clinical outcome and radiological fusion[J/OL]. J Spinal Disord Tech, 2012, 18. http://www.ncbi.nlm.nih.gov/pubmed/?term=PEEK+Cages+in+Lumbar+Fusion%3A+Mid-term+Clinical+Outcome+and+Radiological+Fusion.
29.	Chen CS, Chen WJ, Cheng CK, et al. Failure analysis of broken pedicle screws on spinal instrumentation[J]. Med Eng Phys, 2005, 27(6):487-496.

1. Chrastil J, Patel AA. Complications associated with posterior and transforaminal lumbar interbody fusion[J]. J Am Acad Orthop Surg, 2012, 20(5):283-291.
2. Deyo RA, Martin BI, Kreuter W, et al. Revision surgery following operations for lumbar stenosis[J]. J Bone Joint Surg Am, 2011, 93(21):1979-1986.
3. Yu SW, Yen CY, Wu CH, et al. Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years[J]. Arch Orthop Trauma Surg, 2012, 132(5):583-589.
4. Zagra A, Minoia L, Archetti M, et al. Prospective study of a new dynamic stabilisation system in the treatment of degenerative discopathy and instability of the lumbar spine[J]. Eur Spine J, 2012, 21(Suppl 1):S83-S89.
5. Kim KA, McDonald M, Pik JH, et al. Dynamic intraspinous spacer technology for posterior stabilization:case-control study on the safety, sagittal angulation, and pain outcome at 1-year follow-up evaluation[J]. Neurosurg Focus, 2007, 22(1):E7.
6. McDowell I, Newell C. Measuring health:a guide to rating scales and questionnaires[M]. 2nd ed. New York:Oxford University Press, Inc., 1996:446-456.
7. Fairbank JC, Pynsent PB. The Oswestry Disability Index[J]. Spine (Phila Pa 1976), 2000, 25(22):2940-2952.
8. Fritz JM, Irrgang JJ. A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale[J]. Phys Ther, 2001, 81(2):776-788.
9. Pekkanen L, Kautiainen H, Ylinen J, et al. Reliability and validity study of the Finnish version 2.0 of the oswestry disability index[J]. Spine (Phila Pa 1976), 2011, 36(4):332-338.
10. Blumenthal S, Mcafee PC, Guyer RD, et al. A prospective, randomized, multicenter Food and Drug Administration investigational device exemptions study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion:partⅠ:evaluation of clinical outcomes[J]. Spine (Phila Pa 1976), 2005, 30(14):1565-1575; discussion E387-E391.
11. Geisler FH, Blumenthal S, Guyer RD, et al. Neurological complications of lumbar artificial disc replacement and comparison of clinical results with those related to lumbar arthrodesis in the literature:results of a multicenter, prospective, randomized investigational device exemption study of Charité intervertebral disc. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004[J]. J Neurosurg Spine, 2004, 1(2):143-154.
12. Zigler J, Delamarter R, Spivak JM, et al. Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease[J]. Spine(Phila Pa 1976), 2007, 32(11):1155-1162.
13. Fritzell P, H?gg O, Wessberg P, et al. 2001 Volvo Award Winner in Clinical Studies:lumbar fusion versus nonsurgical treatment for chronic low back pain:a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group[J]. Spine(Phila Pa 1976), 2001, 26(23):2532-2534.
14. Lee C, Dorcil J, Radomisli TE. Nonunion of the spine:a review[J]. Clin Orthop Relat Res, 2004(419):71-75.
15. Gornet MF, Burkus JK, Dryer RF, et al. Lumbar disc arthroplasty with Maverick disc versus stand-alone interbody fusion:a prospective, randomized, controlled, multicenter investigational device exemption trial[J]. Spine (Phila Pa 1976), 2011, 36(25):E1600-E1611.
16. Brantigan JW, Steffee AD, Lewis ML, et al. Lumbar interbody fusion using the Brantigan I/F cage for posterior lumbar interbody fusion and the variable pedicle screw placement system:two-year results from a Food and Drug Administration investigational device exemption clinical trial[J]. Spine (Phila Pa 1976), 2000, 25(11):1437-1446.
17. Burkus JK. Intervertebral fixation:clinical results with anterior cages[J]. Orthop Clin North Am, 2002, 33(2):349-357.
18. Duffield RC, Carson WL, Chen LY, et al. Longitudinal element size effect on load sharing, internal loads, and fatigue life of tri-level spinal implant constructs[J]. Spine (Phila Pa 1976), 1993, 18(12):1695-1703.
19. Templier A, Denninger L, Mazel C, et al. Comparison between two different concepts of lumbar posterior osteosynthesis implants A finite-element analysis[J]. Eur J Orthop Surg Traumatol, 1998, 8(1):27-36.
20. Goel VK, Gilbertson LG. Basic science of spinal instrumentation[J]. Clin Orthop Rel, 1997, 335:10-31.
21. Wolff J. The Law of Bone Remodeling[M]. Berlin Heidelberg New York:Springer, 1986.
22. Frost HM. A 2003 update of bone physiology and Wolff's Law for clinicians[J]. Angle Orthod, 2004, 74(1):3-15.
23. Champain S, Mazel C, Mitulescu A, et al. Quantitative analysis in outcome assessment of instrumented lumbosacral arthrodesis[J]. Eur Spine J, 2007, 16(8):1241-1249.
24. Wendsche P. "Dynamic fusion" in lumbar spine degenerative disorders Mid-term results[J]. ArgoSpine News J, 2010, 22(2):67-70.
25. Barrey CY. Dynamic instrumentation for fusion with Isobar TTL^TM:biomechanical and clinical aspects[J]. ArgoSpine News J, 2010, 22(2):62-66.
26. Jacobs WC, Van Der Gaag NA, Kruyt MC, et al. Total disc replacement for chronic discogenic low back pain:a Cochrane review[J]. Spine (Phila Pa 1976), 2013, 38(1):24-36.
27. Park CK, Ryu KS, Lee KY, et al. Clinical outcome of lumbar total disc replacement using ProDisc-L in degenerative disc disease:minimum 5-year follow-up results at a single institute[J]. Spine (Phila Pa 1976), 2012, 37(8):672-677.
28. Schimmel JJ, Poeschmann MS, Horsting PP, et al. PEEK cages in lumbar fusion:mid-term clinical outcome and radiological fusion[J/OL]. J Spinal Disord Tech, 2012, 18. http://www.ncbi.nlm.nih.gov/pubmed/?term=PEEK+Cages+in+Lumbar+Fusion%3A+Mid-term+Clinical+Outcome+and+Radiological+Fusion.
29. Chen CS, Chen WJ, Cheng CK, et al. Failure analysis of broken pedicle screws on spinal instrumentation[J]. Med Eng Phys, 2005, 27(6):487-496.

West China Medical Journal

Clinical Study of Elastic Fixation for Lumbar Intervertebral Fusion

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