19 44 20151022 Chinese Journal of Tissue Engineering Research October 22, 2015 Vol.19, No.44 Waveflex ( 221009) 1 Waveflex 2 3 Waveflex Waveflex (XZB201311) Waveflex Waveflex 38 18 Waveflex 20 (JOA)Oswestry (ODI) X 1220 JOA ODI (P < 0.05) JOA ODI (P < 0.05) (P < 0.05)Waveflex 1979 221009 :R318 :A :2095-4344 (2015)44-07131-06 2015-09-21 http://www.crter.org. Waveflex [J].201519(44):7131-7136. doi:10.3969/j.issn.2095-4344.2015.44.015 Waveflex elastic fixation and discectomy annulus in repair and reconstruction of spinal stability in patients with lumbar disc herniation Zhang Zhao-chuan, Jiang Xiao-wei, Dai Wei-xiang, Wu De-hui, Ma Chao, Wang Zhao-hong, Han Meng, Feng Jie, Liu Guang-pu (Department of Orthopedics, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China) Abstract BACKGROUND: For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate. OBJECTIVE: To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed small window nucleus pulposus extirpation associated with annulus repair. METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar small window nucleus pulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of follow-up study Zhang Zhao-chuan, Studying for doctorate, Attending physician, Department of Orthopedics, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China Corresponding author: Jiang Xiao-wei, M.D., Attending physician, Department of Orthopedics, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China Accepted: 2015-09-21 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 7131
. Waveflex was conducted, including: follow-up analysis of clinical efficacy and complications, collection of low-back pain visual analogue scores, collection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators. RESULTS AND CONCLUSION: Follow-up visits to the patients were conducted 1220 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Still in the last follow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaller than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults. Subject headings: Lumbar Vertebrae; Intervertebral Disk Displacement; Internal Fixators; Follow-up; Tissue Engineering Funding: a Science and Technology Project Funded by Xuzhou Central Hospital Medical Doctor s Innovation Team, No.XZB201311. Zhang ZC, Jiang XW, Dai WX, Wu DH, Ma C, Wang ZH, Han M, Feng J, Liu GP. Waveflex elastic fixation and discectomy annulus in repair and reconstruction of spinal stability in patients with lumbar disc herniation. Zhongguo Zuzhi Gongcheng Yanjiu. 2015;19(44):7131-7136. 0 Introduction [1] 2030MixterBarr [2] [3] 70 7132 [4] Waveflex2011 18 + Waveflex 1Subjects and methods 1.1 1.2 2012120155 1.3 Waveflex Medyssey 1.4 38184018 Waveflex 20 L 4/5 (P > 0.05) L 4/5 P.O. Box 10002, Shenyang 110180
. Waveflex 3 1.5 Magerl4 C ()2 mm 24 mm U 1 CX 1 24 h 24 h 2448 h24 h 3 d 2 1.6 [5] (Japanese Orthopaedic Association ScoresJOA)Oswestry (ODI) [6] 1612 X 10 cm 010 ODI 10( )() () 106 05 5 010 /50() 100% /45() 100% JOA4 9AB/C3 430 6() 332 014 1 h7 320 603 629 1.7 SPSS 19.0 (SPSS) x±st t 2 P < 0.05 2Results 2.1 38 1220 2.2 1 2.3 JOA ODI JOAODI (P < 0.05)12(P < 0.05)16123 (P > 0.05) JOAODI (P < 0.05)2 2.4 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 7133
. Waveflex A B C D F G H I E 1 28 Waveflex Figure 1 Radiographs of lumbar disc protrusion patients (Male, 28 years old) before and after Waveflex elastic fixation associated with small window nucleus pulposus excision annulus repair AB X CD MRIE CT L L +waveflex FG X HI 15 X 1 Table 1 Comparison of basic information of patients in these two groups P (x±s) 28.2±6.4 26.9±6.1 > 0.05 (/n) 14/4 12/8 > 0.05 (x±skg) 69.9±5.4 73.1±4.6 > 0.05 (x±s) 9.9±3.9 10.0±2.8 > 0.05 (P > 0.05) 3 (x±s) Table 3 Comparison of disc height, the range of motion in lesions segments before surgery and at final follow-up in these two groups (P > 0.05) (P < 0.05)3 2.5 2.6 28 L 4/5 +Waveflex 1 3Discussion (n=18) (n=20) (mm) 7.7±0.3 7.7±0.2 0.274 > 0.05 9.5±0.3 6.4±0.5 25.771 < 0.05 ( ) 7.4±0.3 7.5±0.3 0.648 > 0.05 5.3±0.4 7.6±0.2 22.635 < 0.05 (P < 0.05) 4.26%0.12 [7] t P 2 1612 JOA ODI (x±s) Table 2 Comparison of visual analogue scores, Japanese Orthopaedic Association scores and Oswestry dysfunction index before surgery, 1 month, 6 months, 12 months after surgery and at final follow-up in these two groups (n=18) (n=20) 5.8±1.4 6.1±1.3 0.502 > 0.05 1 2.7±0.7 3.0±1.0 1.207 > 0.05 6 1.9±0.7 2.1±0.8 0.654 > 0.05 12 1.4±0.5 2.2±0.4 5.047 < 0.05 0.9±0.5 1.8±1.0 3.279 < 0.05 JOA 9.9±2.1 10.0±1.8 0.097 > 0.05 1 19.8±2.3 20.0±1.8 0.861 > 0.05 6 23.8±2.1 23.0±1.7 1.262 > 0.05 12 25.2±1.4 23.1±1.7 4.181 > 0.05 25.4±1.5 20.4±2.2 8.199 < 0.05 ODI 25.4±1.4 22.0±1.6 6.800 > 0.05 1 9.4±1.7 9.8±2.2 0.629 > 0.05 6 7.4±1.7 7.4±1.5 0.022 > 0.05 12 6.6±1.5 6.7±1.3 0.213 > 0.05 4.4±1.5 6.4±2.4 2.864 < 0.05 P < 0.05 12 1612 3 (P > 0.05)JOA ODI (P < 0.05) [8] 49.0%89.6% [9] [10] CTMRI [11] t P 7134 P.O. Box 10002, Shenyang 110180
. Waveflex Maigen [12] 90% 36 [13-15] 5%10% [16-17] [18] [19-20] Waveflex Medyssey2007 2011 10 5 Waveflex Waveflex JOAODI [21] [22] [23-25] 5%10% Barth [26] 9 10%Jerosch [27] 846 9311% ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 7135
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