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Journal of Korean Neurosurgical Society 1998;27(2): 207-214. |
Treatment of Degenerative Lumbar Instability with Semi-Rigid Isolock System. |
Yong Eun Cho, Young Soo Kim, Byung Ho Jin, Gilles PERRIN |
1Department of Neurosurgery, Yonsei University, College of Medicine, Seoul, Korea. 2Hopital Neurologique Pierre Wertheimer CHU de Lyon, France. |
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ABSTRACT |
For degenerative lumbar instability, various spinal instrumentations have been used to relieve clinical symptom and to stabilize the spine. Most of them are rigid fixation which cause a postfusion instability at adjacent segment with high incidence. It creates a highly susceptible region(neo-hinge) between fixed rigid segment and nonfixed mobile segment. Eventually acceleration of degenerative change in adjacent segment is resulted with clinical deterioration. To avoid of postfusion instability after rigid fixation, a semi-rigid fixation system which has a intermediate transitional zone is developed. In 98 patients with degenerative lumbar instability, semi-rigid fixation which had a damper in the middle of plate were performed with CH titanium cage. Angular instability in lateral dynamic X-ray was improved in all case immediately after operation. Translational instability also much improved. But no degenerative change or instability in adjacent segment(neo-hinge disc) or overlying disc within fusion segment during follow up period of average 16 months.
Excellent and good clinical results were achieved in 90.8% of patients and the solid bone fusion was occurred in 98.9%. |
Key Words:
Postfusion instability; Transitional zone; Neo-hinge disc; Semi-rigid fixation |
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