Comparison of the clinical effects between bilateral vertebral facet joint fusion and interbody fusion cage implantation combined with pedicle internal fixation in the treatment of degenerative lumbar instability
GAO Fei
WANG Gao-qiang
ARiBenJiRiGaLa
JIANG Fu-xiang
WANG Xing
ZHANG Hong-lai
Abstract：Objective To compare the clinical effects of bilateral vertebral facet joint fusion and interbody fusion cage implantation in the treatment of lumbar instability.Methods From December 2008 to December 2015, 143 patients with degenerative lumbar instability were treated by surgery, including 51 males and 92 females, whose mean age was 56 years old ( range: 45 - 65 years old ). Among them, 60 patients underwent pedicle screw fixation combined with bilateral vertebral facet joint fusion ( group A ), and 83 patients underwent pedicle screw rod system fixation combined with interbody fusion ( group B ). The visual analogue scale ( VAS ) scores preoperatively and at 1 day after the surgery and Oswenstry disability index ( ODI ) scores preoperatively and at 6 weeks after the surgery were recorded to evaluate the clinical effects. The vertebral facet joint fusion was evaluated based on lumbar hyperextension and hyperflexion lateral X-ray films and CT images at 9 months after the surgery. The operation time, intraoperative blood loss and drainage at 1 day after the surgery between group A and group B were compared.Results No statistically significant differences existed in the VAS scores preoperatively and at 1 day after the surgery and ODI scores preoperatively and at 6 weeks after the surgery (P > 0.05 ). There were no statistically significant differences between the 2 groups (P> 0.05 ) in the angles based on the lumbar hyperextension and hyperflexion lateral X-ray films and CT images preoperatively and at 9 months after the surgery. The operation time [ group A: ( 65.3 ± 15.8 ) min, group B: ( 118.4 ± 15.2 ) min ], intraoperative blood loss [ group A: ( 103.4 ± 30.2 ) ml, group B: ( 350.6 ± 30.9 ) ml ] and drainage at 1 day after the surgery [ group A: ( 60.5 ± 15.7 ) ml, group B: ( 123.1 ± 25.6 ) ml ] between the 2 groups were compared, and the differences were statistically significant (P < 0.05 ).Conclusions The operative method of pedicle screw rod system fixation, spinal canal decompression and vertebral facet joint fusion in the treatment of lumbar degenerative instability is simple and easy to perform, and the curative results are satisfactory.
Keywords：Spinal fusionArthrodesisLumbar vertebraeComparative effectiveness research
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 216-219 )