Abstract
Introduction
We present our experience of 22 patients with low grade degenerative lumbar spondylolysthesis with stenosis (21 Grade I and 1 Grade II) who were treated using new stabilization systems {Scient'x IsoBar TTL Dynamic Rod Stabilization and the Inlign™ Multi-Axial pedicle Screws (Disc Motion Technologies - DMT)}.
Methodology and Results
The pain intensity was evaluated using the Visual Analogue Score for back pain (VAS-BP) and leg pain (VAS-LP) and functional outcomes using Oswestry Disability Score (ODS). Overall improvement in general patient's health was assessed using the Bodily Pain (SF36-BP) component of the SF -36 questionnaires. Data was analysed with the SPSS 16.0 for Windows (SPSS Inc, Chicago, IL). Statistical significance was designated at p < 0.05 and appropriate parametric (Paired sample t-test) and non parametric tests (Wilcoxon signed-rank test) were used.
There were 3 male and 19 female patients and average age at operation was 68.95 years (57-79 years). The average duration of follow up was 16.18 months (8-37 months). Most common level of surgery was L4/5 (n=18). Decompression and instrumentation involved 1 level (7 cases), 2 levels (9 cases), 3 levels (1 case) and 4 levels (5 cases). There was statistically significant improvement in all clinical outcomes. The ODS improved from 49.45 ±14.35 pre-operatively to 22.91 ± 6.38 post operatively (p< 0.001). There was statistically significant improvement noted in VAS-BP (p< 0.001), VAS-LP (p<0.001) and SF36-BP (p=0.002).
Conclusion
The recent dynamic stabilisation systems were developed with an intention to stabilise the spondylolisthetic segment and preventing adjacent level degeneration. The study results clearly demonstrate that central decompression and dynamic stabilization using TTL/DMT system for degenerative lumbar spondylolysthesis is a safe, reliable method and offers excellent clinical outcomes. This technique obviates the need of bone graft and hence the graft site pain.
