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題 名 | Dynesys-Transition-Optima Does Not Reduce the Risk of Adjacent Segment Degeneration Comparing to Posterolateral Fusion: Radiological and Clinical Outcomes |
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作 者 | Tung, Kuan-kai; Liu, Cheng-sheng; Tseng, Sheng-chei; Lin, Yu-hsein; Wu, Yun-che; Shih, Cheng-min; Chen, Kun-hui; Lee, Cheng-hung; Pan, Chien-chou; | 書刊名 | Formosan Journal of Musculoskeletal Disorders |
卷 期 | 14:3 2023.07-09[民112.07-09] |
頁 次 | 頁77-85 |
分類號 | 416.6 |
關鍵詞 | Adjacent segment degeneration; Dynesys‑transition‑optima; Posterolateral fusion; Spinal fusion; |
語 文 | 英文(English) |
DOI | 10.4103/FJMD.FJMD_331 |
英文摘要 | Background: At present, there are no existing studies that have conducted a comparative analysis between posterolateral fusion (PLF) and dynamic fusion utilizing the Dynesys‑Transition‑Optima (DTO) hybrid system regarding adjacent segment degeneration (ASD). Objectives: The objective of this study was to assess and compare the radiological and clinical short‑term outcomes of PLF with those achieved through dynamic fusion using the DTO hybrid system. Materials and Methods: This retrospective study included 115 consecutive patients (DTO group: n = 33; PLF group: n = 82) who were followed up for at least 2 years after surgery. Radiological parameters such as disc height, vertebra dimensions, lordosis, and range of motion (ROM), as well as clinical outcomes, including pain scores and disability index, were collected and analyzed using statistical tests. Results: Postoperatively, the adjacent segment ROM significantly decreased in the PLF group during both follow‑up periods. The PLF group also exhibited a significantly greater reduction in adjacent ROM than the DTO group from baseline to the final follow‑up. Similarly, the PLF group demonstrated a significant decrease in adjacent listhesis/adjusted by the upper vertebra’s anteroposterior diameter (APD) from baseline to the last follow‑up, while no significant changes were observed in the DTO group. In addition, the decrease in adjacent listhesis/APD was more pronounced in the PLF group compared to the DTO group. Both groups showed similar improvements in EuroQol‑5 dimensions, Visual Analog Scale‑back pain, and Oswestry Disability Index scores. Conclusions: The use of the DTO hybrid system for dynamic fusion did not exhibit a significant protective effect against ASD. However, both dynamic fusion using the DTO hybrid system and posterolateral fusion (PLF) seemed to provide similar pain relief and improvements in the quality of life during the mid‑term follow‑up period. |
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