Impact of Lumbar Fusion Internal Fixation on Lumbar Disc Herniation in Young Patients: A Retrospective Study

Overview

Journal Med Sci Monit

Specialties General Medicine
Pathology

Date 2024 Oct 28

PMID 39462889

Authors

Jichao Guo

Guohui Xu

Sheng Li

Zhiyong Li

Jianning Liu

Wei Wang

XiangBei Qi

Wenyuan Ding

Xu Li

Affiliations

Soon will be listed here.

Abstract

BACKGROUND Lumbar fusion and internal fixation techniques have shown promise in treating lumbar disc herniation (LDH), yet the impact on lumbar function in young patients remains unclear. This study aimed to investigate the impact of lumbar fusion on lumbar function in young patients. MATERIAL AND METHODS A retrospective analysis was conducted on 330 patients diagnosed with LDH admitted to our hospital. Patients were divided into 2 groups: a control group (n=264) that underwent a minimally invasive procedure with a keyhole lens, and a research group (n=66) that underwent lumbar fusion internal fixation. Clinical features and therapeutic outcomes were assessed using Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) Lumbar Scores before surgery and 12 months postoperatively. Additionally, intervertebral space height, degree of vertebral spondylolisthesis (grades I, II, and III), incidence of adverse effects, and treatment efficacy were measured pre-and post-surgically. RESULTS No significant difference in ODI and JOA scores was found between the groups before surgery (P>0.05). Postoperatively, the research group had lower ODI scores, higher JOA scores, and lower intervertebral space heights compared to the control group (P=0.001). While grade 1 and 2 spondylolisthesis showed slight improvement (P>0.05), a significant difference was observed in grade III spondylolisthesis between the 2 groups (P=0.001). Additionally, the research group had a lower incidence of adverse effects (P=0.049) and higher treatment efficacy, although the difference was not statistically significant (P>0.05). CONCLUSIONS Lumbar fusion with internal fixation produced better postoperative outcomes and fewer adverse effects than minimally invasive procedures in young patients with lumbar disc herniation.

References

Wang Z, Wang B, Yin B, Liu W, Yang F, Lv G . The relationship between spinopelvic parameters and clinical symptoms of severe isthmic spondylolisthesis: a prospective study of 64 patients. Eur Spine J. 2013; 23(3):560-8. PMC: 3940809. DOI: 10.1007/s00586-013-3064-2. View

Kang H . Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021; 18:17. PMC: 8441096. DOI: 10.3352/jeehp.2021.18.17. View

Patel A, Walker C, Prendergast V, Radosevich J, Grimm D, Godzik J . Patient-Controlled Analgesia Following Lumbar Spinal Fusion Surgery Is Associated With Increased Opioid Consumption and Opioid-Related Adverse Events. Neurosurgery. 2020; 87(3):592-601. DOI: 10.1093/neuros/nyaa111. View

Benzakour A, Benzakour T . Lumbar disc herniation: long-term outcomes after mini-open discectomy. Int Orthop. 2019; 43(4):869-874. DOI: 10.1007/s00264-019-04312-2. View

Kuribayashi M, Takahashi K, Fujioka M, Ueshima K, Inoue S, Kubo T . Reliability and validity of the Japanese Orthopaedic Association hip score. J Orthop Sci. 2010; 15(4):452-8. DOI: 10.1007/s00776-010-1490-0. View

Zhang Y, Yuan S, Chen X, Zhang Z, Yang X, Wang S . Risk Factors for Surgical Treatment of Lumbar Degenerative Disc Disease in Middle-aged and Older Women: A Prospective Case-Control Study of 2370 Subjects. Orthop Surg. 2024; 16(6):1284-1291. PMC: 11144512. DOI: 10.1111/os.14066. View

Koivunen K, Widbom-Kolhanen S, Pernaa K, Arokoski J, Saltychev M . Reliability and validity of Oswestry Disability Index among patients undergoing lumbar spinal surgery. BMC Surg. 2024; 24(1):13. PMC: 10765861. DOI: 10.1186/s12893-023-02307-w. View

Paoloni M, Di Sante L, Cacchio A, Apuzzo D, Marotta S, Razzano M . Intramuscular oxygen-ozone therapy in the treatment of acute back pain with lumbar disc herniation: a multicenter, randomized, double-blind, clinical trial of active and simulated lumbar paravertebral injection. Spine (Phila Pa 1976). 2009; 34(13):1337-44. DOI: 10.1097/BRS.0b013e3181a3c18d. View

Delgado-Lopez P, Rodriguez-Salazar A, Martin-Alonso J, Martin-Velasco V . [Lumbar disc herniation: Natural history, role of physical examination, timing of surgery, treatment options and conflicts of interests]. Neurocirugia (Astur). 2017; 28(3):124-134. DOI: 10.1016/j.neucir.2016.11.004. View

10.

Kang Y, Ho Y, Chu W, Chou W, Cheng S . Effects and Safety of Lumbar Fusion Techniques in Lumbar Spondylolisthesis: A Network Meta-Analysis of Randomized Controlled Trials. Global Spine J. 2021; 12(3):493-502. PMC: 9121149. DOI: 10.1177/2192568221997804. View

11.

Abdu W, Sacks O, Tosteson A, Zhao W, Tosteson T, Morgan T . Long-Term Results of Surgery Compared With Nonoperative Treatment for Lumbar Degenerative Spondylolisthesis in the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2018; 43(23):1619-1630. PMC: 6185822. DOI: 10.1097/BRS.0000000000002682. View

12.

Suri P, Hunter D, Jouve C, Hartigan C, Limke J, Pena E . Inciting events associated with lumbar disc herniation. Spine J. 2010; 10(5):388-95. PMC: 2919742. DOI: 10.1016/j.spinee.2010.02.003. View

13.

Chen P, Wang C, Ren Y, Ye Z, Jiang C, Wu Z . Alterations in the gut microbiota and metabolite profiles in the context of neuropathic pain. Mol Brain. 2021; 14(1):50. PMC: 7941960. DOI: 10.1186/s13041-021-00765-y. View

14.

Sun Z, Qi Y . Application of enhanced recovery after surgery care protocol in the perioperative care of patients undergoing lumbar fusion and internal fixation. J Orthop Surg Res. 2022; 17(1):240. PMC: 9014593. DOI: 10.1186/s13018-022-03099-0. View

15.

Wan Z, Shan H, Liu T, Song F, Zhang J, Liu Z . Emerging Issues Questioning the Current Treatment Strategies for Lumbar Disc Herniation. Front Surg. 2022; 9:814531. PMC: 8999845. DOI: 10.3389/fsurg.2022.814531. View

16.

Levin J, Tanenbaum J, Steinmetz M, Mroz T, Overley S . Posterolateral fusion (PLF) versus transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis: a systematic review and meta-analysis. Spine J. 2018; 18(6):1088-1098. DOI: 10.1016/j.spinee.2018.01.028. View

17.

Awad J, Moskovich R . Lumbar disc herniations: surgical versus nonsurgical treatment. Clin Orthop Relat Res. 2006; 443:183-97. DOI: 10.1097/01.blo.0000198724.54891.3a. View

18.

Jung B, Han J, Song J, Ngan A, Essig D, Verma R . Interventional Therapy and Surgical Management of Lumbar Disc Herniation in Spine Surgery: A Narrative Review. Orthop Rev (Pavia). 2023; 15:88931. PMC: 10667270. DOI: 10.52965/001c.88931. View

19.

Logroscino C, Proietti L, Pola E, Scaramuzzo L, Tamburrelli F . A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities. Eur Spine J. 2011; 20 Suppl 1:S41-5. PMC: 3087039. DOI: 10.1007/s00586-011-1762-1. View

20.

Qian J, Bao Z, Li X, Zou J, Yang H . Short-Term Therapeutic Efficacy of the Isobar TTL Dynamic Internal Fixation System for the Treatment of Lumbar Degenerative Disc Diseases. Pain Physician. 2016; 19(6):E853-61. View