title: Kirschner wire is more effective than the nerve root retractor in treating patients with disc herniation.
abstract: OBJECTIVE
  To investigate the value of using Kirschner wire in the intraspinal procedures.
  
  
  METHODS
  From May 2011 to October 2013, a total of 46 patients with a single-level lumbar disc herniation with concomitant lumbar instability were randomly assigned to two groups at the time of admission. Group 1 had 23 patients who underwent posterior lumbar fusion using a nerve root retractor to drag nerve root, and Group 2 also had 23 patients who underwent the same operation by fixing Kirschner wires in the vertebral body to drag nerve root. All of these patients were assessed with visual analog scales (VAS) and Japanese Orthopaedic Association (JOA) scores before surgery, and were followed up at the time points of one week (VAS score only), three, six, and twelve months respectively after surgery. The actual retraction time of the nerve root of each patient was also recorded during the operation.
  
  
  RESULTS
  The differences in VAS and JOA scores were not significant between Group 1 and 2 before surgery. However, these scores showed significant improvement in Group 2 at one week and three months after surgery compared with those in Group 1. At six and twelve month follow-up time points, no significant difference was observed between these two groups. However, the retraction time of the nerve root of the patients in Group 2 was significantly shorter than in Group 1.
  
  
  CONCLUSIONS
  Using Kirschner wires instead of the nerve root retractor to pull nerve root in the patients with a single-level lumbar disc herniation accompanied by the lumbar instability is more effective in reducing the dragging damage of the nerve root at early phases after surgery and in shortening retraction time.
authors.affiliation: Department of Orthopaedics, No. 2 People's Hospital of Wuhu, China.
authors.forename: Yetian
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, No. 2 People's Hospital of Wuhu, China.
authors.forename: Xiaohai
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, No. 2 People's Hospital of Wuhu, China.
authors.forename: Zhiyang
authors.initials: Z
authors.lastname: Kong
authors.affiliation: Department of Orthopaedics, No. 2 People's Hospital of Wuhu, China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, No. 2 People's Hospital of Wuhu, China. Electronic address: liyetian1984@163.com.
authors.forename: Guangye
authors.initials: G
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001864:Bone Wires; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013126:Spinal Nerve Roots / Q000293:injuries*; D013525:Surgical Instruments; D016896:Treatment Outcome
keywords: Kirschner wire; Lumbar disc herniation; Nerve root injury; Nerve root retractor; Spinal fusion