title: [Long-term follow-up study on expandable Cage in treatment of degenerative lumbar disease].
abstract: OBJECTIVE
  To explore the long-term effectiveness of expandable Cage in treatment of degenerative lumbar disease.
  
  
  METHODS
  Between January 2005 and January 2008, 72 patients with degenerative lumbar disease were treated by expandable Cage and followed up for 5 years. Of 72 cases, 41 were male and 31 were female with an average age of 40.5 years (mean, 35-65 years), including 35 cases of lumbar spinal stenosis, 20 cases of degenerative lumbar instability, and 17 cases of serious lumbar intervertebral disc protrusion combined with lumbar instability. The disease duration was 6-28 months (mean, 9 months). The affected lumbar segments were L3,4 in 6 patients, L4,5 in 37 patients, and L5, S1 in 29 patients. The Oswestry disability index (ODI) was used to evaluate the effectiveness before and after operation and to calculate the improvement rate. During the follow-up, the anteroposterior, lateral, and dynamic X-ray films were taken to evaluate the operated segment fusion rate. The intervertebral lordosis angle was measured, and adjacent segment degeneration was observed.
  
  
  RESULTS
  The operation time was 35-90 minutes (mean, 65 minutes); the intraoperative blood loss was 200-450 mL (mean, 280 mL), and all the patients received intraoperative autologous blood transfusion; the postoperative bedridden time was 3-7 days (mean, 4.5 days); the hospitalization days were 10-18 days (mean, 12 days). No complications of nerve root injury, cauda equina injury, or cerebrospinal fluid leakage occurred during operation. All patients achieved primary healing of the incisions. All 72 patients were followed up for 5 years. At 3 months, 1 year, and 5 years after operation, the ODI were 8.2 +/- 2.6, 6.9 +/- 1.9, and 6.4 +/- 1.3 respectively, showing significant differences when compared with preoperative value (41.5 +/- 3.5) (P < 0.05); the improvement rates were 87.3% +/- 1.2%, 90.1% +/- 0.8%, and 91.6% +/- 1.3% respectively, showing no significant difference (F=0.492, P=0.375); the intervertebral lordosis angles were (5.1 +/- 1.2), (5.0 +/- 0.5), and (5.4 +/- 0.8) degrees respectively, showing no significant difference (F=0.570, P=0.453). At 5 years after operation, the intervertebral fusion rate was 100%, with no adjacent segment degeneration.
  
  
  CONCLUSIONS
  Using expandable Cage to treat degenerative lumbar disease can get stabilization without pedicle screw fixation, the good effectiveness is shown after long-term follow-up.
authors: Enzhi
authors: E
authors: Liu
authors: Qingshui
authors: Q
authors: Yin
authors: Dongming
authors: D
authors: Guo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007593:Joint Instability; D008159:Lumbar Vertebrae; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000601:surgery*; D016896:Treatment Outcome