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KMID : 1099620080050030136
Korean Journal of Spine
2008 Volume.5 No. 3 p.136 ~ p.141
Follow-up Comparison Study of Single-level Posterior Dynamic Stabilization in Lumbar Degenerative Disease ¡¯Interspinous U¡¯ vs. ¡¯DIAM¡¯
Yoon Seong-Min

Kim Woo-Kyung
Lee Sang-Gu
Kim Eun-Young
Abstract
Objective:Although successful fusion rates have approached almost 100%, fusion may increase the biomechanical stresses imposed on the adjacent segments leading to transitional disease. These issues have leg some investigators to explore novel approaches, that is ¡¯posterior dynamic stabilization¡¯. In this study, we compared clinical outcome of two different posterior dynamic stabilization instruments: ¡¯Interspinous U¡¯ and ¡¯DIAM¡¯ device, respectively.

Methods:A retrospective review was performed for all the patients with disc degenerative diseases treated with decompression procedure from 2004 to 2007. The plain lateral and flexion-extension views were taken immediately after surgery and at each follow-up. The disc height ratio(DH), total lumbar lordotic angle (TLA) and segmental lordotic angle (SLA) were used to observe the change of initial status. The clinical outcome was measured by Odom¡¯s criteria and compared. Also, in lateral view, decrease of bony density around instruments was regarded as bony erosion.

Results: Mean follow-up durations for ¡¯Interspinous U¡¯ and ¡¯DIAM¡¯ were 39 and 14 months, respectively. Instruments were used for 21 and 16 patients for ¡¯Interspinous U and ¡¯DIAM¡¯ groups, respectively. Satisfactory groups were 61% and 74% for ¡¯Interspinous U and ¡¯DIAM¡¯ groups. But, there was no statistical difference between two groups in the change of DH, TLA and SLA. In ¡¯Interspinous U¡¯ group, two cases showed spinal instability with bony erosion, and five cases showed bony erosion around instruments.

Conclusions:¡¯DIAM¡¯group showed higher patient satisfaction and no bony erosion. To ascertain the difference, analysis with larger population and a long-term follow-up period will be needed.
KEYWORD
Degenerative Lumbar Disease, Interspinous device
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