Radiological and clinical comparisons of the patients with rheumatoid arthritis operated with rigid and dynamic instrumentation systems due to lumbar degenerative spinal diseases |
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| Authors: | Orkun Koban Ahmet Ö?renci Ezgi Ayçiçek Akar Ahmet Sad?k Uyan?k Mesut Y?lmaz Sedat Dalbayrak |
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| Affiliation: | 1. Okan University, Department of Neurosurgery, Istanbul, Turkey;2. Haydarpa?a Numune Research and Training Hospital, Department of Neurosurgery, Istanbul, Turkey;3. Okan University, Department of Radiology, Istanbul, Turkey;4. Neurospinal Academy, Department of Neurosurgery, Istanbul, Turkey;1. Dept. of Orthop. Surg., Hokkaido Medical Center for Child Health and Rehabilitation, Japan;2. Dept. of Physical Therapy, Hokkaido Medical Center for Child Health and Rehabilitation, Japan;3. Dept. of Prosthetics and Orthotics, Hokkaido University of Science, Japan;4. Dept. of Orthop. Surg., Sapporo Child Development General Support Center, Japan;5. Dept. of Orthop. Surg., Sapporo Medical University, Japan;1. Department of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University School of Medicine, Goyangsi, Gyeonggido, South Korea;2. School of Medicine, Sungkyunkwan University, Seoul, South Korea;3. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea |
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| Abstract: | BackgroundIt is extremely difficult to treat spine disorders with stabilization in patients with rheumatoid arthritis. Because revision rates are significantly higher in rigid stabilization. To date, there is no data about patients with rheumatoid arthritis treated with dynamic stabilization. Our aim was to compare the radiological and clinical results of patients with rheumatoid arthritis who underwent lumbar rigid stabilization or dynamic stabilization with Polyetheretherketone rod (PEEK).MethodsPatients with degenerative lumbar spine disease with rheumatoid arthritis who underwent dynamic stabilization between 2013 and 2015 and rigid stabilization between 2010 and 2012 were evaluated radiologically for adjacent segment disease, proximal junctional kyphosis, system problem (nonunion, screw loosening, instrumentation failure, pull out). It was also compared according to both the revision rates and the Visual Analog Scale and Oswestry Disability Index scores at the 12th month and 24th month.ResultsThe difference of decrease in Visual Analog Scale and Oswestry Disability Index scores from preoperative to 12th month between patients who underwent dynamic stabilization and rigid stabilization was statistically insignificant. However, there was a significant difference of increase in Visual Analog Scale and Oswestry Disability Index scores between the 12th month and 24th month of patients who underwent rigid stabilization, compared with patients with dynamic stabilization. In patients with dynamic stabilization, the problems of instrumentation were seen less frequently. Revision rates were high in patients with rigid stabilization when compared the patients with dynamic stabilization.ConclusionRadiological and clinical outcomes in patients with rheumatoid arthritis operated with dynamic stabilization are more significant when compared to rigid stabilization. These patients have lower pain and disability scores in their follow up periods. Revision rates are lower in patients with dynamic stabilization. |
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