A short-term comparison of discectomy and discectomy plus dynamic neutralization system for lumbar disc herniation
LIU Yuan-bin
ZHANG Zhi
ZHENG Jia-zhuang
WANG Fan-dong
CHEN Yu
CAI Qi-lin
Abstract：Objective To compare clinical efifcacy of discectomy and discectomy plus dynamic neutralization system ( Dynesys ) in the treatment of lumbar disc herniation, and assess the effects of two kinds of operations on postoperative lumbar activity.Methods Sixty-one patients ( 36 males and 25 females ) with L4-5 disc herniation were treated by discectomy or discectomy plus Dynesys from May 2009 to January 2011, with more than 3 years’ follow-up. The average age was 40.5 years old ( range: 29-61 years ). Thirty-two cases were treated with discectomy plus Dynesys, and 29 cases were treated with discectomy. Clinical outcomes were evaluated by preoperative and postoperative visual analogue scales ( VAS ), and Oswestry disability index ( ODI ). Intervertebral space, range of motion ( ROM ) of the surgical segments and adjacent segment were measured as well.Results A total of 61 patients completed the ifnal follow-up. The mean duration of follow-up was 39.1 months ( range: 36-41 months ). The scores of VAS and ODI decreased signiifcantly after surgery and at the ifnal follow-up (P<0.05 ). The improvement rate of VAS and ODI in the group of discectomy plus Dynesys was higher than that of discectomy group, with statistical signiifcance (P<0.05 ). The intervertebral space was signiifcant increased in the group of discectomy plus Dynesys after surgery with statistical signiifcance (P<0.05 ), and surgical segment ROM was signiifcant decreased after surgery (P<0.05 ). The intervertebral space was significant decreased in the group of discectomy at the final follow-up (P<0.05 ), but surgical segment ROM had no signiifcant changes after surgery (P>0.05 ). There were no signiifcant changes at the adjacent segments in both group (P>0.05 ). The postoperative surgical segment ROM in discectomyplus Dynesys was less than discectomy with statistical significance (P<0.05 ). The postoperative intervertebral space in discectomy plus Dynesys was greater than discectomy with statistical signiifcance (P<0.05 ). No statistical signiifcance existed in the intervertebral space and ROM of surgical and adjacent segments ( P>0.05 ).Conclusions Both discectomy and discectomy plus Dynesys are apparently effective in the treatment of lumbar disc herniation. Discectomy plus Dynesys can keep the surgical segment ROM and stability without obvious inlfuence on adjacent segments.
Keywords：Intervertebral disc displacementLumbar vertebraeDiskectomyPercutaneousDynesys
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 488-493 )