Objective: To investigate the short-term effectiveness of ISOBAR TTL semi-rigid dynamic stabilization system (ISOBAR TTL system) in treatment of lumbar degenerative disease.
Methods: Between June 2007 and May 2011, 38 cases of lumbar degenerative disease were treated, including 24 males and 14 females with an average age of 51.2 years (range, 21-67 years). The disease duration was 8 months to 10 years (mean, 4.7 years). In 38 cases, there were 4 cases of grade I spondylolisthesis, 11 cases of lumbar instability and lumbar disc protrusion, 21 cases of lumbar spinal stenosis and lumbar disc protrusion, and 2 cases of postoperative recurrence of lumbar disc protrusion. There were 22 cases of adjacent segment disc degeneration. All cases underwent posterior decompression and implantation of ISOBAR TTL system. The double-segment-fixed patients underwent interbody fusion. Visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores for low back pain were used to evaluate clinical outcomes. The range of motion (ROM) at the semi-rigid dynamic stabilization segment was also measured.
Results: The other cases achieved healing of incision by first intention, except 1 case of delayed healing. All the patients were followed up 8-53 months (mean, 27.8 months). After operation, ISOBAR TTL system showed reliable fixation, and no loosening, breakage, or kyphosis deformity occurred. No adjacent segment degeneration was observed. The ROM of the fixed segments was 0-1 degrees in 3 cases, 1-2 degrees in 4 cases, 2-3 degrees in 14 cases, 3-4 degrees in 15 cases, and > 4 degrees in 2 cases. At last follow-up, the VAS score was 1.93 +/- 2.43, and was significantly lower than preoperative score (8.20 +/- 1.78) (t = 7.761, P = 0.000). JOA score was 23.06 +/- 7.75, and was significantly higher than preoperative score (4.87 +/- 3.44) (t = 10.045, P = 0.000). According to Stauffer-Coventry evaluation standard, the results were excellent in 32 cases, good in 3 cases, fair in 2 cases, and poor in 1 case, with an excellent and good rate of 92.1%.
Conclusion: Good short-term effectiveness can be achieved by surgical intervention with ISOBAR TTL system in treatment of lumbar degenerative disease.