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MRI analysis of the ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs: a comparison with rigid internal fixation.

Gao J, Zhao W, Zhang X, Nong L, Zhou D, Lv Z, Sheng Y, Wu X - J Orthop Surg Res (2014)

Bottom Line: The upper-segment discs of the fusion were subjected to Pfirrmann grading, and the lumbar intervertebral discs in the DWI sagittal plane were manually drawn; the apparent diffusion coefficient (ADC) value was measured.ADC values in the ISOBAR TTL dynamic fixation group measured at the 6-, 12-, and 24-month postoperative MRI studies were increased compared to the preoperative ADC values.MRI imaging findings indicated that the posterior approach lumbar ISOBAR TTL internal fixation system can prevent or delay the degeneration of intervertebral discs.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital, Nanjing Traditional Chinese Medical University, Changzhou 213003, China. XiZhangdoc@126.com.

ABSTRACT

Objectives: Using magnetic resonance imaging (MRI), we analyzed the efficacy of the posterior approach lumbar ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs, with particular emphasis on its effects on degenerative intervertebral disc disease.

Methods: We retrospectively compared the MRIs of 54 patients who had previously undergone either rigid internal fixation of the lumbar spine or ISOBAR TTL dynamic fixation for the treatment of lumbar spondylolisthesis. All patients had received preoperative and 6-, 12-, and 24-month postoperative MRI scans of the lumbar spine with acquisition of both routine and diffusion-weighted images (DWI). The upper-segment discs of the fusion were subjected to Pfirrmann grading, and the lumbar intervertebral discs in the DWI sagittal plane were manually drawn; the apparent diffusion coefficient (ADC) value was measured.

Results: ADC values in the ISOBAR TTL dynamic fixation group measured at the 6-, 12-, and 24-month postoperative MRI studies were increased compared to the preoperative ADC values. The ADC values in the ISOBAR TTL dynamic fixation group at 24 months postoperatively were significantly different from the preoperative values (P < 0.05). At 24 months, the postoperative ADC values were significantly different between the rigid fixation group and the ISOBAR TTL dynamic fixation group (P < 0.05).

Conclusion: MRI imaging findings indicated that the posterior approach lumbar ISOBAR TTL internal fixation system can prevent or delay the degeneration of intervertebral discs.

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Related in: MedlinePlus

Patient with L4/L5 spondylolisthesis I grade, L5/S1 and L4/L5 protrusion of intervertebral disc, spinal stenosis. The patient is female and 64 years old. (A) Preoperative lumbar radiograph. (B) Preoperative lumbar lateral film. (C) MRI of the lumbar spine, intervertebral disc degeneration, L4/L5 intervertebral disc degeneration, V grade. (D) ISOBAR TTL internal fixation system, L3/L4 implanted microactuator device, the postoperative lumbar radiograph. (E) Postoperative lumbar lateral film. (F) Lumbar intervertebral disc MRI after 2 years, L3/L4 grade III degeneration, L4/L5 grade IV intervertebral disc degeneration.
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Figure 1: Patient with L4/L5 spondylolisthesis I grade, L5/S1 and L4/L5 protrusion of intervertebral disc, spinal stenosis. The patient is female and 64 years old. (A) Preoperative lumbar radiograph. (B) Preoperative lumbar lateral film. (C) MRI of the lumbar spine, intervertebral disc degeneration, L4/L5 intervertebral disc degeneration, V grade. (D) ISOBAR TTL internal fixation system, L3/L4 implanted microactuator device, the postoperative lumbar radiograph. (E) Postoperative lumbar lateral film. (F) Lumbar intervertebral disc MRI after 2 years, L3/L4 grade III degeneration, L4/L5 grade IV intervertebral disc degeneration.

Mentions: The intervertebral space was opened, and an intervertebral fusion cage was implanted at the lesion segment. Using autologous bone implantation and fusion, restoring of spondylolisthesis, and connecting rod, the micromotion device of the ISOBAR TTL group was fixed to the rear of the adjacent facet joint (Figure 1D,E and Figure 2D,E).


MRI analysis of the ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs: a comparison with rigid internal fixation.

Gao J, Zhao W, Zhang X, Nong L, Zhou D, Lv Z, Sheng Y, Wu X - J Orthop Surg Res (2014)

Patient with L4/L5 spondylolisthesis I grade, L5/S1 and L4/L5 protrusion of intervertebral disc, spinal stenosis. The patient is female and 64 years old. (A) Preoperative lumbar radiograph. (B) Preoperative lumbar lateral film. (C) MRI of the lumbar spine, intervertebral disc degeneration, L4/L5 intervertebral disc degeneration, V grade. (D) ISOBAR TTL internal fixation system, L3/L4 implanted microactuator device, the postoperative lumbar radiograph. (E) Postoperative lumbar lateral film. (F) Lumbar intervertebral disc MRI after 2 years, L3/L4 grade III degeneration, L4/L5 grade IV intervertebral disc degeneration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4060636&req=5

Figure 1: Patient with L4/L5 spondylolisthesis I grade, L5/S1 and L4/L5 protrusion of intervertebral disc, spinal stenosis. The patient is female and 64 years old. (A) Preoperative lumbar radiograph. (B) Preoperative lumbar lateral film. (C) MRI of the lumbar spine, intervertebral disc degeneration, L4/L5 intervertebral disc degeneration, V grade. (D) ISOBAR TTL internal fixation system, L3/L4 implanted microactuator device, the postoperative lumbar radiograph. (E) Postoperative lumbar lateral film. (F) Lumbar intervertebral disc MRI after 2 years, L3/L4 grade III degeneration, L4/L5 grade IV intervertebral disc degeneration.
Mentions: The intervertebral space was opened, and an intervertebral fusion cage was implanted at the lesion segment. Using autologous bone implantation and fusion, restoring of spondylolisthesis, and connecting rod, the micromotion device of the ISOBAR TTL group was fixed to the rear of the adjacent facet joint (Figure 1D,E and Figure 2D,E).

Bottom Line: The upper-segment discs of the fusion were subjected to Pfirrmann grading, and the lumbar intervertebral discs in the DWI sagittal plane were manually drawn; the apparent diffusion coefficient (ADC) value was measured.ADC values in the ISOBAR TTL dynamic fixation group measured at the 6-, 12-, and 24-month postoperative MRI studies were increased compared to the preoperative ADC values.MRI imaging findings indicated that the posterior approach lumbar ISOBAR TTL internal fixation system can prevent or delay the degeneration of intervertebral discs.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital, Nanjing Traditional Chinese Medical University, Changzhou 213003, China. XiZhangdoc@126.com.

ABSTRACT

Objectives: Using magnetic resonance imaging (MRI), we analyzed the efficacy of the posterior approach lumbar ISOBAR TTL internal fixation system for the dynamic fixation of intervertebral discs, with particular emphasis on its effects on degenerative intervertebral disc disease.

Methods: We retrospectively compared the MRIs of 54 patients who had previously undergone either rigid internal fixation of the lumbar spine or ISOBAR TTL dynamic fixation for the treatment of lumbar spondylolisthesis. All patients had received preoperative and 6-, 12-, and 24-month postoperative MRI scans of the lumbar spine with acquisition of both routine and diffusion-weighted images (DWI). The upper-segment discs of the fusion were subjected to Pfirrmann grading, and the lumbar intervertebral discs in the DWI sagittal plane were manually drawn; the apparent diffusion coefficient (ADC) value was measured.

Results: ADC values in the ISOBAR TTL dynamic fixation group measured at the 6-, 12-, and 24-month postoperative MRI studies were increased compared to the preoperative ADC values. The ADC values in the ISOBAR TTL dynamic fixation group at 24 months postoperatively were significantly different from the preoperative values (P < 0.05). At 24 months, the postoperative ADC values were significantly different between the rigid fixation group and the ISOBAR TTL dynamic fixation group (P < 0.05).

Conclusion: MRI imaging findings indicated that the posterior approach lumbar ISOBAR TTL internal fixation system can prevent or delay the degeneration of intervertebral discs.

Show MeSH
Related in: MedlinePlus