gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Lumbosacral circumferential arthrodesis and preventive semirigid posterior fixation of adjacent disc

Lumbosakrale, 360° Fusion und vorbeugende semirigide posteriore Fixation der angrenzenden Bandscheibe

Meeting Abstract

Suche in Medline nach

  • corresponding author G. Perrin - Hôpital Neurologique P.Wertheimer, Lyon, France

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.07.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc179.shtml

Veröffentlicht: 11. April 2007

© 2007 Perrin.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: This retrospective study was dedicated to determine the benefits of the semi-rigid protection of the adjacent level in the subgroup of patients with long-term follow-up over 8 years.

In this series, 430 patients have been operated between 1993 and 2000 for lumbar stabilization and 290 patients were reviewed with long-term follow-up. The evolution of the discs adjacent to a semirigid fixation was followed in 22 patients operated on between 06/93 and 04/97 for assessment of the long-term benefits of the adjacent semi-rigid protection after a mean follow-up of 8.27 yrs. The existence of degenerative lesions at the level above the instrumentation after a 8-year follow-up would assess the efficacy of the semi-rigid system and the efficiency of the transitional non-fused intervertebral zone created between the rigid fused segment and the hypermobile hypersollicitated level above the instrumentation.

285 patients demonstrated radiological bone fusion. The clinical outcome was excellent in 109 patients, good in 121 patients, fair in 53 patients and poor in 7 patients. In the subgroup of 22 patients with follow-up >8yrs., spontaneous facets joints fusion was documented in 4 cases. Persistence of intervertebral motion was evident in 15 cases. Conservation of the discal intervertebral height was well documented in 18 cases. Severe new degenerative lesions at the neo-hinge "free" disc adjacent to the instrumention was observed in only 1 case. Persistence of intervertebral motion of this disk was evident in 21 cases with a normal range of motion over 4° in 10 cases. Harmonious lordosis was documented in 16 cases.

Distractive PLIF and posterior fixation in compression is an efficient technique for decompression and stabilization with an optimal 98.3% fusion rate. The absence of degenerative lesions at the level above the instrumentation after long-term follow-up in 96% of the patients give evidence of the reliability of the semi-rigid system and evidence of efficiency of the transitional non-fused intervertebral zone created between the rigid fused segment and the hypermobile hypersollicitated level above the instrumentation. Fusion with cages, restoration of lumbar lordosis, semi-rigid fixation for protection of pathological adjacent disc, avoidance of postoperative corset collectively meet all the requirements not only for pain relief but also for definitive stabilisation without complication or further adjacent degeneration.