Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 24043
KINEMATIC EVALUATION OF THE ADJACENT SEGMENTS AFTER LUMBAR
INSTRUMENTED SURGERY: A COMPARISON BETWEEN RIGID FUSION AND
DYNAMIC NON-FUSION STABILIZATION
Tsubasa SAKAI, Yuichiro MORISHITA, Hideki OHTA, Yoshiyuki MATSUMOTO,
George HUANG, Yoshiharu TAKEMITSU, Hirotaka KIDA
Oita Orthopaedic Hospital, Oita (JAPAN)
Introduction: The aims of the current study were to evaluate changes in lumbar
kinematics after lumbar instrumented surgery with rigid fusion and dynamic nonfusion
stabilization. Methods: A total of 77 lumbar spinal stenosis patients with L4
degenerative spondylolisthesis underwent L4-5 monosegmental posterior
instrumented surgery. Of these, 36 patients were treated with rigid fusion (TLIF) and
41 with dynamic stabilization (Segmental Spinal Correction System (SSCS)). The
clinical outcomes were evaluated by JOA score. Lumbar kinematics were evaluated
with functional radiographs preoperatively and at final follow-up postoperatively. We
defined the contribution of each segmental mobility to the total lumbar mobility as the
percent segmental mobility (sagittal angular motion of each segment in degrees) /
(total sagittal angular motion in degrees) × 100). MRI was performed on all patients
at 2-week and final follow-up postoperatively. The discs were classified into 5 grades
based on the previously reported system. We defined the progress of disc
degeneration as (grade at final follow-up) - (grade at 2 weeks postoperatively).
Results: No significant kinematical differences were shown at any of the lumbar
segments preoperatively; however, significant differences were observed at the L2-3,
L4-5, and L5-S1 segments postoperatively between the groups. At final follow-up, all
of the lumbar segments with rigid fusion demonstrated significantly greater disc
degeneration than those with dynamic stabilization. Conclusions: Our results suggest
that the SSCS preserved 14% of the kinematical operations at the instrumented
segment. The SSCS may prevent excessive effects on adjacent segmental
kinematics and may prevent the incidence of adjacent segment disorder.
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