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Functional and radiological outcomes of semi-rigid dynamic lumbar stabilization adjacent to single-level fusion after 2 years

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Objective

To prospectively evaluate the functional and radiological outcomes of Isobar semi-rigid dynamic posterior stabilization adjacent to single-level fusion up to and including 24 months postoperatively.

Method

A prospective follow-up for 24 months of 36 patients who underwent posterior Isobar dynamic stabilization due to single-level degenerative lumbar discopathy and instability (DLDI) with mild adjacent level degeneration, with collection of functional [visual analog scale (VAS) and Oswestry Disability Index (ODI)] and radiological data (resting, functional X-rays and MRI).

Results

Functional outcomes at 24 months showed significant improvement in mean VAS score by 38.9 points (P < 0.01) and ODI by 22.4 points (P < 0.01). Compared with data preoperatively, disc height at the index and adjacent levels and intervertebral angle (IVA) at the index level showed a slight decreasing trend at each follow-up (P > 0.05), while IVA at the adjacent level showed a slight increasing trend (P > 0.05). Range of motion averaged 2.84° at the index level and remained unchanged at the adjacent level (P > 0.05). The mean Pfirrmann score changed from 2.86 preoperatively to 2.92 at 24 months postoperatively at the index level (P > 0.05), and from 1.92 preoperatively to 1.96 at 24 months postoperatively at the adjacent level (P > 0.05). No reoperation, loosening of screws or infection was recorded.

Conclusions

Patients with single-level DLDI and mild adjacent level degeneration treated with Isobar stabilization show a clinical improvement after 2 years. However, disc degeneration at the index and adjacent levels seems to continue despite using semi-rigid dynamic stabilization.

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Acknowledgments

This work was supported by the Key Project of Science and Technology Commission of Shanghai Municipality (Grant No. 05JC14034), the Selecting and Training Outstanding Young Teachers in Shanghai Universities (Grant No. jdy08068), the National Nature Science Foundation of China (Grant No. 81201424), the Projects of Shanghai Municipal Health Bureau (Grant No. 2012332), the Program for Shanghai Key Laboratory of Orthopaedic Implant (Grant no. 08DZ2230330), and the Open Fund Project of Key Laboratory of Jiangsu Province Interventional Medical Devices (Grant No. JR1104).

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, 200011, Shanghai, People’s Republic of China

    Lingjie Fu, Youzhuan Xie, Kai Fang, Yaokai Gan & Pu Zhang

  2. Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, People’s Republic of China

    Lingjie Fu, Youzhuan Xie, Kai Fang, Yaokai Gan & Pu Zhang

  3. Spine Education and Research Institute, Thornton, CO, USA

    Alexandra France

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  1. Lingjie Fu
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  2. Alexandra France
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  3. Youzhuan Xie
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Correspondence to Pu Zhang.

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Fu, L., France, A., Xie, Y. et al. Functional and radiological outcomes of semi-rigid dynamic lumbar stabilization adjacent to single-level fusion after 2 years. Arch Orthop Trauma Surg 134, 605–610 (2014). https://doi.org/10.1007/s00402-014-1961-4

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  • DOI: https://doi.org/10.1007/s00402-014-1961-4

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