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Journal of Korean Neurosurgical Society 2003;33(3): 252-258.
Differences in Biomechanical Factors for Fusion Transition Syndrome of Lumbar Spine between Pedicle Screw Fixation and Posterior Lumbar Interbody Fusion Groups.
Seung Won Park, Young Baeg Kim, Sung Nam Hwang, Duck Young Choi, Byung Kook Min, Jong Sik Suk
Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea.
We present the investigation of the biomechanical factors of the degeneration process after lumbar fusion.
Thirty-five patients underwent L4-5 fusion operation. We measured radius(cm), top angle(TA)(degree), and flexion-extension angle(FEA) at L3-4 joint in pedicle screw fixation(PSF)(n=27) and posterior lumbar interbody fusion(PLIF)(n=8)groups. They were divided into early(3 to 6 months) and late(over 1 year) groups according to post-operative period. RESULTS: The pre-operative radius, TA and FEA in PSF were 6.2+/-0.4, 9.0+/-0.8, and 8.2+/-0.8. The early and late post-operative radius, TA and FEA in PSF were 6.4+/-0.5, 6.9+/-0.8, 6.8+/-0.8, and 5.5+/-0.7, 12.1+/-0.9, 11.0+/-0.9, respectively. The pre-operative radius, TA and FEA in PLIF were 5.4+/-0.5, 8.9+/-0.8, and 9.5+/-1.2. The early and late post-operative Radius, TA and FEA in PLIF were 5.0+/-0.4, 5.8+/-0.9, 5.2+/-0.7, and 5.0+/-0.5, 8.4+/-0.9, 7.6+/-0.8, respectively. In late PSF, TA and FEA were significantly increased(p<0.05)but radius was significantly decreased (p<0.05) compared with pre-operative ones. But in late PLIF, all the factors were decreased compared with pre-operative ones. CONCLUSION: Biomechanical factors of chronic complications were different between PSF and PLIF. Increased FEA seems to be an important factor for post-operative degeneration in PSF, whereas increased stiffness and stress seems more important in PLIF.
Key Words: Degenerative complications; Pedicle screw fixation; Posterior lumbar interbody fusion; Biomechanical factors
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