Influence of isobar ttl dynamic internal fixation system on adjacent segment degeneration by mri measurement of lumbar nucleus pulposus volume_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANGWenqiang ,  SHAOGaohai , LIBo , YUYu , QUYiming , WANGQunbo

Department of Orthopedics, Yongchuan Hospital of Chongqing Medical University, Yongchuan Chongqing, 402160, P. R. China;

Corresponding?author：

SHAOGaohai, Email: shaogaohai567@163.com

Keywords：

ISOBAR TTL dynamic internal fixation; Nucleus pulposus volume; Intervertebral disc degeneration

DOI：

10.7507/1002-1892.20160174

Video：

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Objective To investigate the influence of ISOBAR TTL dynamic internal fixation system on degeneration of adjacent intervertebral disc by MRI measurement of lumbar nucleus pulposus volume in treating lumbar degenerative disease after operation. Methods Between March 2010 and October 2011, 34 patients with lumbar intervertebral disc herniation (23 cases of paracentral type and 11 cases of lateral type) underwent operation with ISOBAR TTL dynamic internal fixation system for fixation of single segment, and the clinical data were analyzed retrospectively. There were 20 males and 14 females, aged 39-62 years (mean, 47.5 years). The disease duration was 6-18 months (mean, 14 months). Involved segments included L_{4, 5} in 21 cases and L₅, S₁ in 13 cases. The X-ray films and MRI images were taken at 6, 12, 18, 24, 36, and 48 months after surgery. Based on X-ray films, the height of intervertebral space was measured using angle bisectrix method. The nucleus pulposus volume was measured based on the MRI scan. The postoperative change of nucleus pulposus volume and intervertebral disc height were used to evaluate the influence of ISOBAR TTL system on degeneration of adjacent intervertebral disc nucleus pulposus. Results Thirty patients were followed up 48 months. The height of intervertebral space showed no significant difference between at pre-and post-operation (P>0.05). The nucleus pulposus volume increased after operation, showing no significant difference at 6, 12, and 18 months when compared with preoperative value (P>0.05), but significant difference was found at 24, 36, and 48 months when compared with preoperative value (P < 0.05). The height of nucleus pulposus increased after operation but the width was decreased; the values showed no significant difference at 6, 12, and 18 months when compared with preoperative ones, but showed significant difference at 24, 36, and 48 months when compared with preoperative ones (P < 0.05). The diameter of nucleus pulposus at 18, 24, 36, and 48 months after operation was significantly langer than that at preoperation (P < 0.05). Conclusion ISOBAR TTL dynamic internal fixation system can prevent or delay the degeneration of intervertebral discs.

Citation： HUANGWenqiang, SHAOGaohai, LIBo, YUYu, QUYiming, WANGQunbo. Influence of isobar ttl dynamic internal fixation system on adjacent segment degeneration by mri measurement of lumbar nucleus pulposus volume. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(7): 855-860. doi: 10.7507/1002-1892.20160174 Copy

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3.	Yugué I, Okada S, Masuda M, et al. Risk factors for adjacent segment pathology requiring additional surgery after single-level spinal fusion: impact of pre-existing spinal stenosis demonstrated by preoperative myelography. Eur Spine J, 2016, 25(5): 1542-1549.
4.	Wang Q, Liu J, Shi Y, et al. Short-term effects of a dynamic neutralization system (Dynesys) for multi-segmental lumbar disc herniation. Eur Spine J, 2016, 25(5): 1409-1416.
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6.	魯凱伍, 瞿東濱, 張樹芳, 等.經皮內窺鏡下腰椎間盤切除術治療外側型腰椎間盤突出癥.中國脊柱脊髓雜志, 2010, 20(2): 107-111.
7.	Modic MT, Ross JS. Lumbar degenerative disk disease. Radiology, 2007, 245(1): 43-61.
8.	Stoffel M, Behr M, Reinke A, et al. Pedicle screw-based dynamic stabilization of the thoracolumbar spine with the Cosmic-system: a prospective observation. Acta Neurochir (Wien), 2010, 152(5): 835-843.
9.	Cheh G, Bridwell KH, Lenke LG, et al. Adjacent segment disease followinglumbar/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up. Spine (Phila Pa 1976), 2007, 32(20): 2253-2257.
10.	De la Garza-Ramos R, Kerezoudis P, Sciubba DM, et al. The effect of preoperative diagnosis on the incidence of adjacent segment disease after lumbar fusion. J Neurosurg Sci, 2015. [Epub ahead of print].
11.	Kyaw TA, Wang Z, Sakakibara T, et al. Biomechanical effects of pedicle screw fixation on adjacent segments. Eur J Orthop Traumatol, 2014, 24 Suppl 1: S283-287.
12.	潘志強, 葉立民, 王求永, 等.腰椎融合術后臨近節段椎間盤應力的有限元分析.中外醫學研究, 2014, 12(17): 20-22.
13.	Tang S, Xu W. Does disc space height of fused segment affect adjacent disc degeneration in anterior lumbar interbody fusion? A radiological study. Iran Red Crescent Med J, 2012, 14(3): 139-145.
14.	Masevnin S, Ptashnikov D, Michaylov D, et al. Risk factors for adjacent segment disease development after lumbar fusion. Asian Spine J, 2015, 9(2): 239-244.
15.	Mulholland RC, Sengupta DK. Rationale, principles and experimental evaluation of the concept of soft stabilization. Eur Spine J, 2002, 11 Suppl 2: S198-205.
16.	李爾楠, 葉啟彬, 匡正達.脊柱非融合內固定系統在腰椎退行性疾病治療中的應用進展.檢驗醫學與臨床, 2014, 11(24): 3496-3498.
17.	Niu CC, Yuan LJ, Chen LH, et al. Beneficial effects of hyperbaric oxygen on human degenerated intervertebral disk cells via suppression of IL-1βand p38 MAPK signal. J Orthop Res, 2011, 29(1): 14-19.
18.	吳劍宏, 阮狄克.腰椎間盤退變的MRI診斷分級及其臨床應用進展.中國脊柱脊髓雜志, 2010, 20(6): 511-515.
19.	樓才俊, 陳其昕, 李方才, 等.腰椎間盤髓核退變的MRI表現與病理學的相關性研究.中華骨科雜志, 2005, 23(9): 531-535.
20.	Périé D, Curnier D. Effect of pathology type and severity on the distribution of MRI signal intensities within the degenerated nucleus pulposus: application to idiopathic scoliosis and spondylolisthesis. BMC Musculoskelet Disord, 2010, 11: 189.
21.	Gao J, Zhao W, Zhang X, et al. MRI analysis of the ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs: a comparison with rigid internal fixation. J Orthop Surg Res, 2014, 9: 43.

1. Abbasi H, Abbasi A. Oblique lateral lumbar interbody fusion (OLLIF): technical notes and early results of a single surgeon comparative study. Cureus, 2015, 7(10): e351.
2. 管俊杰, 石志才.腰椎動態固定技術的臨床研究進展.脊柱外科雜志, 2010, 8(1): 59-62.
3. Yugué I, Okada S, Masuda M, et al. Risk factors for adjacent segment pathology requiring additional surgery after single-level spinal fusion: impact of pre-existing spinal stenosis demonstrated by preoperative myelography. Eur Spine J, 2016, 25(5): 1542-1549.
4. Wang Q, Liu J, Shi Y, et al. Short-term effects of a dynamic neutralization system (Dynesys) for multi-segmental lumbar disc herniation. Eur Spine J, 2016, 25(5): 1409-1416.
5. Perez-Orribo L, Zucherman JF, Hsu KY, et al. Biomechanics of a posterior lumbar motion stabilizing device: in vitro comparison to intact and fused conditions. Spine (Phila Pa 1976), 2016, 41(2): E55-63.
6. 魯凱伍, 瞿東濱, 張樹芳, 等.經皮內窺鏡下腰椎間盤切除術治療外側型腰椎間盤突出癥.中國脊柱脊髓雜志, 2010, 20(2): 107-111.
7. Modic MT, Ross JS. Lumbar degenerative disk disease. Radiology, 2007, 245(1): 43-61.
8. Stoffel M, Behr M, Reinke A, et al. Pedicle screw-based dynamic stabilization of the thoracolumbar spine with the Cosmic-system: a prospective observation. Acta Neurochir (Wien), 2010, 152(5): 835-843.
9. Cheh G, Bridwell KH, Lenke LG, et al. Adjacent segment disease followinglumbar/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up. Spine (Phila Pa 1976), 2007, 32(20): 2253-2257.
10. De la Garza-Ramos R, Kerezoudis P, Sciubba DM, et al. The effect of preoperative diagnosis on the incidence of adjacent segment disease after lumbar fusion. J Neurosurg Sci, 2015. [Epub ahead of print].
11. Kyaw TA, Wang Z, Sakakibara T, et al. Biomechanical effects of pedicle screw fixation on adjacent segments. Eur J Orthop Traumatol, 2014, 24 Suppl 1: S283-287.
12. 潘志強, 葉立民, 王求永, 等.腰椎融合術后臨近節段椎間盤應力的有限元分析.中外醫學研究, 2014, 12(17): 20-22.
13. Tang S, Xu W. Does disc space height of fused segment affect adjacent disc degeneration in anterior lumbar interbody fusion? A radiological study. Iran Red Crescent Med J, 2012, 14(3): 139-145.
14. Masevnin S, Ptashnikov D, Michaylov D, et al. Risk factors for adjacent segment disease development after lumbar fusion. Asian Spine J, 2015, 9(2): 239-244.
15. Mulholland RC, Sengupta DK. Rationale, principles and experimental evaluation of the concept of soft stabilization. Eur Spine J, 2002, 11 Suppl 2: S198-205.
16. 李爾楠, 葉啟彬, 匡正達.脊柱非融合內固定系統在腰椎退行性疾病治療中的應用進展.檢驗醫學與臨床, 2014, 11(24): 3496-3498.
17. Niu CC, Yuan LJ, Chen LH, et al. Beneficial effects of hyperbaric oxygen on human degenerated intervertebral disk cells via suppression of IL-1βand p38 MAPK signal. J Orthop Res, 2011, 29(1): 14-19.
18. 吳劍宏, 阮狄克.腰椎間盤退變的MRI診斷分級及其臨床應用進展.中國脊柱脊髓雜志, 2010, 20(6): 511-515.
19. 樓才俊, 陳其昕, 李方才, 等.腰椎間盤髓核退變的MRI表現與病理學的相關性研究.中華骨科雜志, 2005, 23(9): 531-535.
20. Périé D, Curnier D. Effect of pathology type and severity on the distribution of MRI signal intensities within the degenerated nucleus pulposus: application to idiopathic scoliosis and spondylolisthesis. BMC Musculoskelet Disord, 2010, 11: 189.
21. Gao J, Zhao W, Zhang X, et al. MRI analysis of the ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs: a comparison with rigid internal fixation. J Orthop Surg Res, 2014, 9: 43.

Chinese Journal of Reparative and Reconstructive Surgery

Influence of isobar ttl dynamic internal fixation system on adjacent segment degeneration by mri measurement of lumbar nucleus pulposus volume

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