Skip to main content
Erschienen in: International Orthopaedics 4/2019

23.10.2018 | Original Paper

Preliminary efficacy of inter-spinal distraction fusion which is a new technique for lumbar disc herniation

verfasst von: Hongyu Wei, Hai Tang, Tidong Zhang, Hao Chen, Chunke Dong

Erschienen in: International Orthopaedics | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Introduction

To investigate the short- and medium-term efficacy of inter-spinal distraction fusion (ISDF) for lumbar disc herniation with a spinal internal fixation device, the BacFuse Spinous Process Fusion Plate.

Methods

Ninety-five patients who received ISDF between January 2014 and January 2015 were included for the current retrospective study. The symptoms and imaging results before surgery, immediately after surgery, at six months, and at the last follow-up were assessed using the leg visual analogue scale (VAS), Oswestry disability index (ODI), and 12-item short-form survey (SF-12). The intra-operative intervertebral angle (IA), anterior disk height (ADH), posterior disk height (PDH), foramina height (FH), foramina width (FW), and range of motion (ROM) were assessed using X-rays. The foramina and herniated disc area were assessed using computed tomography (CT).

Results

The leg VAS, ODI, and SF-12 were significantly improved after surgery. All indices except ADH were also significantly improved after surgery. PDH and FH increased by 15.5% (P < 0.001) and 9.7% (P < 0.001) at the last follow-up. ROM was statistically different from before surgery. CT images indicated that the herniated disc area decreased by 3.1%, while the foramina areas increased by 5.7% at the last follow-up. 92.6% patients demonstrated successful outcome.

Conclusions

ISDF significantly alleviated the clinical symptoms, improved spinal structure, and partially retracted the herniated disc. Our findings imply that ISDF is an effective minimally invasive procedure in the treatment of lumbar disc herniation.
Literatur
1.
Zurück zum Zitat Kreiner DS, Hwang SW, Easa JE, Resnick DK, Baisden JL, Bess S et al (2014) An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J 14:180–189CrossRefPubMed Kreiner DS, Hwang SW, Easa JE, Resnick DK, Baisden JL, Bess S et al (2014) An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J 14:180–189CrossRefPubMed
2.
Zurück zum Zitat Buttermann GR et al (2004) Treatment of lumbar disc herniation: epidural steroid injection compared with discectomy. A prospective, randomized study. J Bone Joint Surg Am 86:670–679CrossRefPubMed Buttermann GR et al (2004) Treatment of lumbar disc herniation: epidural steroid injection compared with discectomy. A prospective, randomized study. J Bone Joint Surg Am 86:670–679CrossRefPubMed
3.
Zurück zum Zitat Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Hanscom B, Skinner JS et al (2006) Surgical vs nonoperative treatment for lumbar disk herniation: the spine patient outcomes research trial (SPORT). A randomized trial. JAMA 2006(296):2441–2450CrossRef Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Hanscom B, Skinner JS et al (2006) Surgical vs nonoperative treatment for lumbar disk herniation: the spine patient outcomes research trial (SPORT). A randomized trial. JAMA 2006(296):2441–2450CrossRef
4.
Zurück zum Zitat Weber H (1983) Lumbar disc herniation: a controlled, prospective study with ten years of observation. Spine 8:131–140CrossRefPubMed Weber H (1983) Lumbar disc herniation: a controlled, prospective study with ten years of observation. Spine 8:131–140CrossRefPubMed
5.
Zurück zum Zitat Fan G, Han R, Gu X et al (2016) Navigation improves the learning curve of transforamimal percutaneous endoscopic lumbar discectomy[J]. Int Orthop 41(2):1–10 Fan G, Han R, Gu X et al (2016) Navigation improves the learning curve of transforamimal percutaneous endoscopic lumbar discectomy[J]. Int Orthop 41(2):1–10
6.
Zurück zum Zitat Du J, Tang X, Xin J et al (2016) Outcomes of percutaneous endoscopic lumbar discectomy via a translaminar approach, especially for soft, highly down-migrated lumbar disc herniation[J]. Int Orthop 40(6):1247–1252CrossRefPubMed Du J, Tang X, Xin J et al (2016) Outcomes of percutaneous endoscopic lumbar discectomy via a translaminar approach, especially for soft, highly down-migrated lumbar disc herniation[J]. Int Orthop 40(6):1247–1252CrossRefPubMed
7.
Zurück zum Zitat Christie SD, Song JK, Fessler RG (2005) Dynamic interspinous process technology. Spine 30(16 Suppl):S73–S78CrossRefPubMed Christie SD, Song JK, Fessler RG (2005) Dynamic interspinous process technology. Spine 30(16 Suppl):S73–S78CrossRefPubMed
8.
Zurück zum Zitat Kabir SM, Gupta SR, Casey AT (2010) Lumbar interspinous spacers: a systematic review of clinical and biomechanical evidence. Spine 35:E1499–E1506CrossRefPubMed Kabir SM, Gupta SR, Casey AT (2010) Lumbar interspinous spacers: a systematic review of clinical and biomechanical evidence. Spine 35:E1499–E1506CrossRefPubMed
9.
Zurück zum Zitat Bellini CM, Galbusera F, Raimondi MT, Mineo GV, Brayda-Bruno M (2007) Biomechanics of the lumbar spine after dynamic stabilization. J Spinal Disord Tech 20:423–429CrossRefPubMed Bellini CM, Galbusera F, Raimondi MT, Mineo GV, Brayda-Bruno M (2007) Biomechanics of the lumbar spine after dynamic stabilization. J Spinal Disord Tech 20:423–429CrossRefPubMed
10.
Zurück zum Zitat Holinka J, Krepler P, Matzner M et al (2011) Stabilising effect of dynamic interspinous spacers in degenerative low-grade lumbar instability.[J]. Int Orthop 35(3):395–400CrossRefPubMed Holinka J, Krepler P, Matzner M et al (2011) Stabilising effect of dynamic interspinous spacers in degenerative low-grade lumbar instability.[J]. Int Orthop 35(3):395–400CrossRefPubMed
11.
Zurück zum Zitat Gazzeri R, Galarza M, Alfieri A (2014) Controversies about interspinous process devices in the treatment of degenerative lumbar spine diseases: past, present, and future. Biomed Res Int 2014:975052CrossRefPubMedPubMedCentral Gazzeri R, Galarza M, Alfieri A (2014) Controversies about interspinous process devices in the treatment of degenerative lumbar spine diseases: past, present, and future. Biomed Res Int 2014:975052CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Jiang YQ, Che W, Wang HR, Li RY, Li XL, Dong J (2015) Minimum 5 year follow-up of multi-segmental lumbar degenerative disease treated with discectomy and the Wallis interspinous device. J Clin Neurosci 22:1144–1149CrossRefPubMed Jiang YQ, Che W, Wang HR, Li RY, Li XL, Dong J (2015) Minimum 5 year follow-up of multi-segmental lumbar degenerative disease treated with discectomy and the Wallis interspinous device. J Clin Neurosci 22:1144–1149CrossRefPubMed
13.
Zurück zum Zitat Barbagallo GM, Olindo G, Corvino L, Albanese V (2009) Analysis of complications in patients treated with the X-STOP interspinous process decompression system: proposal for a novel anatomic scoring system for patients selection and review of the literature. Neurosurgery 66:1111–1119 Barbagallo GM, Olindo G, Corvino L, Albanese V (2009) Analysis of complications in patients treated with the X-STOP interspinous process decompression system: proposal for a novel anatomic scoring system for patients selection and review of the literature. Neurosurgery 66:1111–1119
14.
Zurück zum Zitat Bowers C, Amini A, Dailey AT, Schmidt MH (2010) Dynamic interspinous process stabilization: review of complications associated with the X-STOP device. Neurosurg Focus 28:E8CrossRefPubMed Bowers C, Amini A, Dailey AT, Schmidt MH (2010) Dynamic interspinous process stabilization: review of complications associated with the X-STOP device. Neurosurg Focus 28:E8CrossRefPubMed
15.
Zurück zum Zitat Kim DH, Tantorski M, Shaw J, Martha J, Li L, Shanti N et al (2011) Occult spinous process fractures associated with interspinous process spacers. Spine 36:E1080–E1085CrossRefPubMed Kim DH, Tantorski M, Shaw J, Martha J, Li L, Shanti N et al (2011) Occult spinous process fractures associated with interspinous process spacers. Spine 36:E1080–E1085CrossRefPubMed
16.
Zurück zum Zitat Kutcha J, Sobottke R, Cysel P, Simons P (2009) Two-year results of interspinous spacer (X-STOP) implantation of 175 patients with neurologic intermittent claudication due to lumbar spinal stenosis. Eur Spine J 18:823–829CrossRef Kutcha J, Sobottke R, Cysel P, Simons P (2009) Two-year results of interspinous spacer (X-STOP) implantation of 175 patients with neurologic intermittent claudication due to lumbar spinal stenosis. Eur Spine J 18:823–829CrossRef
17.
Zurück zum Zitat Xu C, Ni WF, Tian NF et al (2013) Complications in degenerative lumbar disease treated with a dynamic interspinous spacer (Coflex)[J]. Int Orthop 37(11):2199–2204CrossRefPubMedPubMedCentral Xu C, Ni WF, Tian NF et al (2013) Complications in degenerative lumbar disease treated with a dynamic interspinous spacer (Coflex)[J]. Int Orthop 37(11):2199–2204CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK (2014) Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J 14:2525–2545CrossRefPubMed Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK (2014) Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J 14:2525–2545CrossRefPubMed
19.
Zurück zum Zitat Wan Z, Wang S, Kozanek M, Xia Q, Mansfield FL, Lü G et al (2012) The effect of the X-stop implantation on intervertebral foramen, segmental spinal canal length and disc space in elderly patients with lumbar spinal stenosis. Eur Spine J 21:400–410CrossRefPubMed Wan Z, Wang S, Kozanek M, Xia Q, Mansfield FL, Lü G et al (2012) The effect of the X-stop implantation on intervertebral foramen, segmental spinal canal length and disc space in elderly patients with lumbar spinal stenosis. Eur Spine J 21:400–410CrossRefPubMed
20.
Zurück zum Zitat Kim HY, Choi BW (2013) Change of radiological parameters after interspinous implantation (X-stop®) in degenerative spinal stenosis. Eur J Orthop Surg Traumatol 23:281–285CrossRefPubMed Kim HY, Choi BW (2013) Change of radiological parameters after interspinous implantation (X-stop®) in degenerative spinal stenosis. Eur J Orthop Surg Traumatol 23:281–285CrossRefPubMed
21.
Zurück zum Zitat Kumar N, Shah SM, Ng YH, Pannierselvam VK, Dasde S, Shen L (2014) Role of Coflex as an adjunct to decompression for symptomatic lumbar spinal stenosis. Asian Spine J 8:161–169CrossRefPubMedPubMedCentral Kumar N, Shah SM, Ng YH, Pannierselvam VK, Dasde S, Shen L (2014) Role of Coflex as an adjunct to decompression for symptomatic lumbar spinal stenosis. Asian Spine J 8:161–169CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Wang Y, Qian B, Li B, Qin G, Zhou Z, Qiu Y et al (2013) Metal artifacts reduction using monochromatic images from spectral CT: evaluation of pedicle screws in patients with scoliosis. Eur J Radiol 82:e360–e366CrossRefPubMed Wang Y, Qian B, Li B, Qin G, Zhou Z, Qiu Y et al (2013) Metal artifacts reduction using monochromatic images from spectral CT: evaluation of pedicle screws in patients with scoliosis. Eur J Radiol 82:e360–e366CrossRefPubMed
23.
Zurück zum Zitat Veresciagina K, Spakauskas B, Ambrozaitis KV (2010) Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy. Eur Spine J 9:1450–1458CrossRef Veresciagina K, Spakauskas B, Ambrozaitis KV (2010) Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy. Eur Spine J 9:1450–1458CrossRef
24.
Zurück zum Zitat Hoogland T, Schubert M, Miklitz B, Ramirez A (2006) Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine 31:E890–E897CrossRefPubMed Hoogland T, Schubert M, Miklitz B, Ramirez A (2006) Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine 31:E890–E897CrossRefPubMed
25.
Zurück zum Zitat Righesso O, Falavigna A, Avanzi O (2007) Comparison of open discectomy with microendoscopic discectomy in lumbar disc herniations: results of a randomized controlled trial. Neurosurgery 61:545–549CrossRefPubMed Righesso O, Falavigna A, Avanzi O (2007) Comparison of open discectomy with microendoscopic discectomy in lumbar disc herniations: results of a randomized controlled trial. Neurosurgery 61:545–549CrossRefPubMed
26.
Zurück zum Zitat Heyrani N, Picinic Norheim E, Elaine Ku Y, Nick SA (2012) Interspinous process implantation for the treatment of neurogenic intermittent claudication. Anesth Pain Med 2:36–41CrossRefPubMedPubMedCentral Heyrani N, Picinic Norheim E, Elaine Ku Y, Nick SA (2012) Interspinous process implantation for the treatment of neurogenic intermittent claudication. Anesth Pain Med 2:36–41CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Siddiqui M, Smith FW, Wardlaw D (2007) One-year results of X-STOP interspinous implant for the treatment of lumbar spinal stenosis. Spine 32:1345–1348CrossRefPubMed Siddiqui M, Smith FW, Wardlaw D (2007) One-year results of X-STOP interspinous implant for the treatment of lumbar spinal stenosis. Spine 32:1345–1348CrossRefPubMed
28.
Zurück zum Zitat Postacchini F, Postacchini R, Menchetti PP, Sessa P, Paolino M, Cinotti G (2016) Lumbar interspinous process fixation and fusion with stand-alone interlaminar lumbar instrumented fusion implant in patients with degenerative spondylolisthesis undergoing decompression for spinal stenosis. Asian Spine J 10:27–37CrossRefPubMedPubMedCentral Postacchini F, Postacchini R, Menchetti PP, Sessa P, Paolino M, Cinotti G (2016) Lumbar interspinous process fixation and fusion with stand-alone interlaminar lumbar instrumented fusion implant in patients with degenerative spondylolisthesis undergoing decompression for spinal stenosis. Asian Spine J 10:27–37CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Fabrizi AP, Maina R, Schiabello L (2011) Interspinous spacers in the treatment of degenerative lumbar spinal disease our experience with DIAM and Aperius devices. Eur Spine J 20(Suppl 1):S20–S26CrossRefPubMed Fabrizi AP, Maina R, Schiabello L (2011) Interspinous spacers in the treatment of degenerative lumbar spinal disease our experience with DIAM and Aperius devices. Eur Spine J 20(Suppl 1):S20–S26CrossRefPubMed
30.
Zurück zum Zitat Xu D, Chen YH, Zeng HB, Chi YL, Xu HZ (2009) A short-term follow-up results of herniation, a clinical comparison study. Chin J Surg 47:1379–1382PubMed Xu D, Chen YH, Zeng HB, Chi YL, Xu HZ (2009) A short-term follow-up results of herniation, a clinical comparison study. Chin J Surg 47:1379–1382PubMed
31.
Zurück zum Zitat Xu D, Xu HZ, Chen YH, Chi YL, Ni WF, Huang QS et al (2013) Discectomy and discectomy plus Coflex fixation for lumbar disc herniation, a clinical comparison study. Chin J Surg 51:147–151PubMed Xu D, Xu HZ, Chen YH, Chi YL, Ni WF, Huang QS et al (2013) Discectomy and discectomy plus Coflex fixation for lumbar disc herniation, a clinical comparison study. Chin J Surg 51:147–151PubMed
32.
Zurück zum Zitat Wilke HJ, Drumm J, Häussler K, Mack C, Steudel WI, Kettler A (2008) Biomechanical effect of different lumbar interspinous implants on flexibility and intradiscal pressure. Eur Spine J 17:1049–1056CrossRefPubMedPubMedCentral Wilke HJ, Drumm J, Häussler K, Mack C, Steudel WI, Kettler A (2008) Biomechanical effect of different lumbar interspinous implants on flexibility and intradiscal pressure. Eur Spine J 17:1049–1056CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Richards JC, Majumdar S, Lindsey DP, Beaupré GS, Yerby SA (2005) The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine 30:744–749CrossRefPubMed Richards JC, Majumdar S, Lindsey DP, Beaupré GS, Yerby SA (2005) The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine 30:744–749CrossRefPubMed
34.
Zurück zum Zitat Hirsch C, Breque C, Ragot S, Pascal-Mousselard H, Richer JP, Scepi M et al (2015) Biomechanical study of dynamic changes in L4-L5 foramen surface area in flexion and extension after implantation of four interspinous process devices. Orthop Traumatol Surg Res 101:215–219CrossRefPubMed Hirsch C, Breque C, Ragot S, Pascal-Mousselard H, Richer JP, Scepi M et al (2015) Biomechanical study of dynamic changes in L4-L5 foramen surface area in flexion and extension after implantation of four interspinous process devices. Orthop Traumatol Surg Res 101:215–219CrossRefPubMed
35.
Zurück zum Zitat Lee J, Hida K, Seki T et al (2004) An interspinous process distractor (X-STOP) for lumbar spinal stenosis in elderly patients: preliminary experiences in 10 consecutive cases. J Spinal Disord Tech 17:72–77CrossRefPubMed Lee J, Hida K, Seki T et al (2004) An interspinous process distractor (X-STOP) for lumbar spinal stenosis in elderly patients: preliminary experiences in 10 consecutive cases. J Spinal Disord Tech 17:72–77CrossRefPubMed
36.
Zurück zum Zitat Sobottke R, Schlüter-Brust K, Kaulhausen T, Iwasaki Y, Minoru A (2009) Interspinous implants (X Stop, Wallis, Diam) for the treatment of LSS is there a correlation between radiological parameters and clinical outcome. Eur Spine J 18:1494–1503CrossRefPubMedPubMedCentral Sobottke R, Schlüter-Brust K, Kaulhausen T, Iwasaki Y, Minoru A (2009) Interspinous implants (X Stop, Wallis, Diam) for the treatment of LSS is there a correlation between radiological parameters and clinical outcome. Eur Spine J 18:1494–1503CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Park SC, Yoon SH, Hong YP, Kim KJ, Chung SK, Kim HJ (2009) Minimum 2-year follow-up result of degenerative spinal stenosis treated with interspinous u (coflex). J Korean Neurosurg Soc 46:292–299CrossRefPubMedPubMedCentral Park SC, Yoon SH, Hong YP, Kim KJ, Chung SK, Kim HJ (2009) Minimum 2-year follow-up result of degenerative spinal stenosis treated with interspinous u (coflex). J Korean Neurosurg Soc 46:292–299CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Guehring T, Unglaub F, Lorenz H, Omlor G, Wilke HJ, Kroeber MW (2006) Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model. Eur Spine J 15:597–604CrossRefPubMed Guehring T, Unglaub F, Lorenz H, Omlor G, Wilke HJ, Kroeber MW (2006) Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model. Eur Spine J 15:597–604CrossRefPubMed
39.
Zurück zum Zitat Hartmann F, Dietz SO, Kuhn S, Hely H, Rommens PM, Gercek E (2011) Biomechanical comparison of an interspinous device and a rigid stabilization on lumbar adjacent segment range of motion. Acta Chir Orthop Traumatol Cechoslov 78:404–409 Hartmann F, Dietz SO, Kuhn S, Hely H, Rommens PM, Gercek E (2011) Biomechanical comparison of an interspinous device and a rigid stabilization on lumbar adjacent segment range of motion. Acta Chir Orthop Traumatol Cechoslov 78:404–409
40.
Zurück zum Zitat Nandakumar A, Clark NA, Peehal JP, Bilolikar N, Wardlaw D, Smith FW (2010) The increase in dural sac area is maintained at 2 years after X-stop implantation for the treatment of spinal stenosis with no significant alteration in lumbar spine range of movement. Spine J 10:762–768CrossRefPubMed Nandakumar A, Clark NA, Peehal JP, Bilolikar N, Wardlaw D, Smith FW (2010) The increase in dural sac area is maintained at 2 years after X-stop implantation for the treatment of spinal stenosis with no significant alteration in lumbar spine range of movement. Spine J 10:762–768CrossRefPubMed
41.
Zurück zum Zitat Kroeber M, Unglaub F, Guehring T, Nerlich A, Hadi T, Lotz J et al (2005) Effects of controlled dynamic disc distraction on degenerated intervertebral discs: an in vivo study on the rabbit lumbar spine model. Spine 30:181–187CrossRefPubMed Kroeber M, Unglaub F, Guehring T, Nerlich A, Hadi T, Lotz J et al (2005) Effects of controlled dynamic disc distraction on degenerated intervertebral discs: an in vivo study on the rabbit lumbar spine model. Spine 30:181–187CrossRefPubMed
42.
Zurück zum Zitat Kamanli A, Karaca-Acet G, Kaya A, Koc M, Yildirim H (2010) Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Bratisl Lek Listy 111:541–544PubMed Kamanli A, Karaca-Acet G, Kaya A, Koc M, Yildirim H (2010) Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Bratisl Lek Listy 111:541–544PubMed
43.
Zurück zum Zitat Choi J, Lee S, Hwangbo G (2015) Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation. J Phys Ther Sci 27:481–483CrossRefPubMedPubMedCentral Choi J, Lee S, Hwangbo G (2015) Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation. J Phys Ther Sci 27:481–483CrossRefPubMedPubMedCentral
44.
Zurück zum Zitat Sari H, Akarirmak U, Karacan I, Akman H (2005) Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract 21:3–11CrossRefPubMed Sari H, Akarirmak U, Karacan I, Akman H (2005) Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract 21:3–11CrossRefPubMed
45.
Zurück zum Zitat Ozturk B, Gunduz OH, Ozoran K, Bostanoglu S (2006) Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation. Rheumatol Int 26:622–626CrossRefPubMed Ozturk B, Gunduz OH, Ozoran K, Bostanoglu S (2006) Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation. Rheumatol Int 26:622–626CrossRefPubMed
46.
Zurück zum Zitat BenEliyahu DJ (1996) Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. J Manip Physiol Ther 19:597–606 BenEliyahu DJ (1996) Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. J Manip Physiol Ther 19:597–606
Metadaten
Titel
Preliminary efficacy of inter-spinal distraction fusion which is a new technique for lumbar disc herniation
verfasst von
Hongyu Wei
Hai Tang
Tidong Zhang
Hao Chen
Chunke Dong
Publikationsdatum
23.10.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 4/2019
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-4188-0

Weitere Artikel der Ausgabe 4/2019

International Orthopaedics 4/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.