Evaluation of outcomes of discectomy with a dynamic neutralization system in treatment of lumbar disk herniation

Peiran Wei , Yan Xu , Huikang Zhang , Qingqiang Yao , Liming Wang
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Abstract

Objective

The study aimed to explore the clinical outcomes of discectomy with dynamic neutralization system (Dynesys) for single-segmental lumbar disk herniation (LDH) versus simple discectomy.

Methods

The eligible patients with single-segmental LDH were randomly divided into the discectomy with Dynesys group (group A) and the simple discectomy group (group B). The Oswestry disability index (ODI), visual analog score (VAS), radiological results of intervertebral height and range of motion (ROM) of the treated segment were evaluated pre- and post-operatively in both groups. Operation duration and blood loss were recorded. Complications, reoperation, and mortality were also assessed. All patients received a 2-year follow-up.

Results

123 (96.1%) participants completed the follow-up. The operation duration and blood loss of group B were significantly lower than those of group A (p < 0.05). After operation, ODI and VAS were improved significantly in both groups, and there was no significant difference between the two groups immediately after surgery. But a rising trend was found in ODI and VAS of group B, especially after the 1-year follow-up (p < 0.05). X-rays showed a continuing loss of intervertebral height of the treated segment in group B, while it was preserved in group A (p < 0.05). ROM of the treated segment was also maintained stable in group A.

Conclusion

Discectomy with Dynesys is safe and effective for LDH treatment.

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动态中和系统椎间盘切除术治疗腰椎间盘突出症的疗效评价
目的探讨动态中和系统(Dynesys)椎间盘切除术治疗单节段腰椎间盘突出症(LDH)与单纯椎间盘摘除术的临床疗效。方法将符合条件的单节段LDH患者随机分为Dynesys椎间盘切除术组(A组)和单纯椎间盘切除组(B组)。两组患者术前和术后均评估了Oswestry残疾指数(ODI)、视觉模拟评分(VAS)、椎间高度和活动范围(ROM)的放射学结果。记录手术时间和失血量。还评估了并发症、再次手术和死亡率。所有患者均接受了2年的随访。结果123例(96.1%)受试者完成随访。B组的手术时间和失血量均显著低于A组(p<0.05),术后ODI和VAS均明显改善,两组术后即刻无明显差异。但B组的ODI和VAS有上升趋势,尤其是在随访1年后(p<0.05)。X光片显示B组治疗节段椎间高度持续下降,而a组椎间高度保持不变(p>0.05)。a组治疗节节段ROM也保持稳定。结论Dynesys椎间盘切除术治疗LDH安全有效。
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