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SEMI-DYNAMIC STABILIZATION VERSUS POSTERIOR INTERLUMINAR SILICONE DEVICE FOR SINGLE-LEVEL DEGENERATIVE LUMBAR DISEASE: A RETROSPECTIVE COMPARATIVE COHORT FROM VIETNAM
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Introduction: Dynamic stabilization is a surgical option for degenerative lumbar disease with instability or a risk of postoperative instability. In Vietnam, the semi-dynamic B-Dyn device and the interluminar silicone Intraspine® device are commonly used, yet head-to-head data are scarce. This study aims to compare clinical outcomes, segmental mobility, and complications between B-Dyn and Intraspine® in single-level degenerative lumbar disease. Materials and Methods: We retrospectively reviewed patients with single-level lumbar disc herniation and/or lumbar spinal stenosis with segmental instability or a risk of postoperative instability who underwent surgery from January 2018 to December 2021. Outcomes included the Visual Analog Scale (VAS) for low back and radicular pain (preoperative and last follow-up), the Oswestry Disability Index (ODI) (preoperative and last follow-up), and segmental range of motion at the treated level (preoperative and last follow-up). Segmental range of motion (ROM) was measured on dynamic flexion–extension lateral radiographs as the change in the intervertebral angle at the treated level. Complications and reoperations were extracted from medical records. Results: Twenty-eight patients received B-Dyn and 30 received Intraspine®; age was similar (42.68±9.01 vs 43.93±9.02 years; p=0.598). Both groups showed marked pain reduction by the last follow-up. Low back pain improvement was greater with B-Dyn (5.25±1.08) than with Intraspine® (4.37±1.54; p=0.014), while radicular pain improvement was comparable (5.89±0.96 vs 5.43±2.16; p=0.296). ODI improved in both groups and tended to be higher with B-Dyn (61.57±17.09) than with Intraspine® (52.80±24.92; p=0.122). Segmental ROM changed from 3.50±1.91 to 3.14±1.53 with B-Dyn and from 3.20±1.92 to 3.03±1.96 with Intraspine®. Intraspine® had two infections and two recurrent disc herniations requiring reoperation; no complications occurred with B-Dyn. Conclusion: Both devices provided substantial postoperative improvement. B-Dyn achieved greater low back pain improvement, while functional recovery was similar; complications and reoperations occurred only with Intraspine®.
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Từ khóa
Dynamic stabilization; Degenerative lumbar spine; Interspinous device; Functional outcome; Comparative study
Tài liệu tham khảo
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