Abstract
Objective
To assess the effectiveness of dynamic stabilisation as a treatment for discogenic pain compared to standard treatment of interbody fusion.
Study Design & Subjects
All patients were referred for a 2 year back-pain management programme. Patients with continued pain following conservative treatment underwent discography & MRI. Patients with painful degenerate discs on the above investigations were selected.
Patients underwent interbody fusion (PLIF/TLIF) or dynamic stabilisation.
Mean follow-up was 24 months with a minimum follow-up of 12 months.
Outcome Measures
All patients had pre-operative ODI and VAS scores. Patients were then sent further questionnaires at 6 month intervals.
Results
The mean improvement in ODI following dynamic stabilisation was 20% (-20% → 56%), the mean improvement in the pain score was 2.4 (0→8). The mean improvement in ODI following interbody fusion was 11% (-14%→48%), the mean improvement in the pain score was 2.6 (-4→9). 10 patients in the dynamic stabilisation group had a greater than 20% improvement in ODI, 7 patients in the interbody fusion group had similar results.
Conclusion
The above results demonstrate that dynamic stabilisation is at least as effective at treating discogenic pain as interbody fusion. The results however do question the validity of either interbody fusion (PLIF/TLIF) or dynamic stabilisation in the management of discogenic pain.
Conflicts of interest - None
Sources of funding - None
It is confirmed that this abstract has not been published in whole or substantial part nor has it been presented previously at a national meeting.
