Comparison of the clinical efficacy of Topping-off surgery and posterior interbody fusion in the treatment of degenerative lumbar disease

doi:10.3969/j.issn.1006-7795.2022.04.021

Abstract

Abstract: Objective To compare the clinical efficacy of Topping-off surgery with posterior interbody fusion (PIF) in treating degenerative lumbar disease (DLD). Methods Patients who underwent surgery for DLD in Xuanwu Hospital, Capital Medical University from December 2015 to December 2017 were retrospectively reviewed and 40 patients undergoing Topping-off surgery were included. Sixty patients with matched demographic characteristics but undergoing posterior interbody fusion (PIF) surgery were included. All patients were graded for low back pain and lumbar function before and 2 years after surgery. The range of motion (ROM) of L2/3, L3/4, and L2-4 segments were measured with the dynamic lumbar X-rays, and the severity of disc degeneration in L2/3 was assessed with the modified Pfirrmann system. Results The surgical duration in the Topping-off group was significantly shorter than that in the PIF group (P<0.05). The intraoperative blood loss in the Topping-off group was non-significantly less than that in the PIF group (P>0.05). In the Topping-off group, the ROM of the L3/4 segment at two years after surgery was lower than that before surgery (P<0.05), but the ROM of the L2/3 segment was not significantly changed (P>0.05). In the PIF group, the ROM of the L2/3 segment increased significantly at two years after surgery compared with that before surgery (P<0.05). At two years after surgery, no significant difference was detected in the ROM of the L2-4 segment between the two groups (P>0.05), but the modified Pfirrmann score of the L2/3 segment in the PIF group was higher than that in the Topping-off group (P<0.05). Conclusion Both Topping-off surgery and PIF can significantly improve the prognosis of DLD, but Topping-off surgery can prevent or delay the occurrence of adjacent segment degeneration, which is of great significance to the selection of clinical diagnosis and treatment strategies.

Key words: Topping-off surgery, posterior interbody fusion, lumbar degenerative disease, range of motion, adjacent segment degeneration

CLC Number:

Wang Wei, Pan Fumin, Kong Chao, Sun Xiangyao, Hou Xiaofei, Lu Shibao. Comparison of the clinical efficacy of Topping-off surgery and posterior interbody fusion in the treatment of degenerative lumbar disease[J]. Journal of Capital Medical University, 2022, 43(4): 647-652.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2022.04.021

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2022/V43/I4/647

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