Clinical outcomes after posterior dynamic transpedicular stabilization with limited lumbar discectomy: Carragee classification system for lumbar disc herniations

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Fig. 1
(A) Safinaz dynamic transpedicular screw (Medikon). (B) Cosmic dynamic transpedicular screw (Ulrich GmbH & Co. KG).
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Fig. 2
MRI scans in 38 year-old female patient, showing L5 transitional vertebrae and disc herniation in Carragee group IV. The patient had severe back pain and sciatica. (A) The preoperative MRI scan shows a moderate black disc and diffuse bulging. (B) The postoperative MRI scan after posterior dynamic transpedicular stabilization shows deceleration in the degeneration process.

Table 1

Preoperative and postoperative patient characteristics: clinical outcomes according to fragment type and annular defect

	All patients	Fragment-defect group (type II)	Fragment-contained group (type III)	No fragment-contained group (type IV)
N	40 (100%	10 (25%	18 (45%	12 (30%
Mean age (years)	46	48.5	44	47
Mean follow-up (months)	32.75	34.1	31.9	32.9
Gender (F/M)	21/19	4/	8/10	9/
VAS
Preoperative	7	7.2	7	6.75
3-month follow-up	2.5	2.7	2.4	2.5
12-month follow-up	1.05	1.5	1	0.8
24-month follow-up	0.5	0.4	0.75	0.37
ODI
Preoperative	62.8	63.8	61.66	63.66
3-month follow-up	24.45	25.8	25.2	22.16
12-month follow-up	11.29	10	12.12	11.27
24-month follow-up	7.5	6	8.5	7.5
Rate of recurrent/persistent sciatica
3-month follow-up	27.7% (11)	30% (3)	22.2% (4)	33.3% (4)
12-month follow-up	8.1% (3/37)	0%	6.25% (1/16)	18.18% (2/11)
24-month follow-up	8.8% (3/34)	0%	6.26% (1/16)	25% (2/8)
Rate of documented reherniation	None	None	None	None
Rate of reoperation	1	None	None	Malpositioned screw was corrected with a second operation that was performed mo after the first