腰椎内固定融合术后邻近节段退变的影响因素

目的探讨腰椎内固定融合术后邻近节段退变的影响因素。方法对1998年3月至2002年5月33例行腰椎内固定融合术的病例进行随访研究,观察其术后邻近节段退变的发生率、发生年龄、部位、影像学特点以及临床表现,对是否“悬浮固定”、内固定融合范围、不同邻近节段退变的风险进行对比。结果33例患者随访34～82个月,平均4年7个月。发现影像学上有退变表现10例（占30．3％）,10例中有9例退变发生在头侧节段。发生邻近节段退变以60岁以上患者为主。是否进行“悬浮固定”对内固定融合术后邻近节段退变的影响无统计学差异。多节段融合术后较单节段融合术后邻近节段退变有增多的趋势。L2／L3作为邻近节段时退变风险较高,而L5／L1,作为邻近节段退变风险较低。结论头侧邻近节段较尾侧节段更容易发生退变。如果L2／L3可能作为邻近节段,术前有退变表现,术中需将其进行固定融合,而如果L5／S1在术前没有明显退变证据,则不需要将其进行固定融合。腰椎内固定融合时,尽量避免长节段固定融合。     

腰椎经后路椎体间融合后单边或双边固定对邻近节段退变的影响

背景：在行后路椎体融合内固定术中,椎弓根钉置入不可避免会损伤邻近关节突关节。目前一致认为单边固定因保留一侧关节突关节可明显降低邻近节段退变的发生率,但仍缺乏对邻近节段退变的影响因素及不同节段退变发生率的长期随访研究。目的：对比经后路椎体间融合术（posterior lumbar interbody fusion,PLIF）后单边或双边椎弓根螺钉固定对邻近节段退变的影响。方法：2006年2月至2007年12月,101例行PLIF手术的L4-L5椎间盘突出症患者纳入本研究。采用单边固定42例,双边固定59例。所有患者术后随访时间均超过5年。邻近节段分为三个节段：第1个近端邻近节段、第2个近端邻近节段及远端邻近节段。依据末次随访的影像学资料评估邻近节段退变的情况,并记录末次随访时的ODI评分评价腰椎功能。结果：单边固定组第1个近端邻近节段、第2个近端邻近节段及远端邻近节段退变的发生率分别为57.1%（24/42）、45.2%（19/42）、38.1%（16/42）;双边固定组第1个近端邻近节段、第2个近端邻近节段及远端邻近节段退变的发生率分别为72.9%（43/59）、68.0%（40/59）、50.8%（30/59）。两组第1个近端邻近节段和远端邻近节段退变发生率无统计学差异,而第2个近端邻近节段退变发生率具有统计学差异。末次随访时单边固定组和双边固定组的ODI评分分别为25.6±5.9、28.4±5.2,两组具有显著统计学差异（t=-2.503,P=0.014）。结论：对于行腰椎后路减压融合术的单节段腰椎间盘突出症患者,单边固定者邻近节段退变发生率低于双边固定者,尤其对于第2个近端邻近退变节段的患者。     

退变性腰椎不稳固定节段与邻近节段椎间盘退变的关系

目的探讨后路减压、固定、融合术后治疗退变性腰椎不稳的疗效,固定后邻近节段椎间盘退变发生机率与相关性。方法回顾性分析2005年8月～2010年8月下腰椎固定术180例患者的临床资料。结果随访1～5年,其中有症状性退变2例,均为固定近端相邻的椎间盘,而且此阶段椎间盘术前均有不同程度的退变。结论退变性腰椎不稳固定治疗后出现邻近节段椎间盘退变与腰椎固定及固定阶段多少本身无关,与固定前邻近节段椎间盘有无退变关系明显,且多发生于固定节段近端。     

退行性腰椎侧凸后路固定减压选择性植骨融合术后邻近节段退变的临床分析

目的观察后路椎弓根钉内固定、椎管减压、选择性椎间植骨融合术治疗退行性腰椎侧凸术后邻近节段退变发生的情况。方法回顾性分析自2012-01—2015-12采用后路椎弓根钉内固定、椎管减压、选择性椎间植骨融合术治疗的72例退行性腰椎侧凸,A组35例选择L4、5节段融合,B组37例选择L5S1节段融合。比较2组多节段固定比例、多椎板间隙减压比例,术后1周矢状面Cobb角、冠状面Cobb角、JOA评分,以及邻近节段退变发生率。结果 A组随访(14.1±1.2)个月,B组随访(12.8±0.2)个月。A组单椎板间隙减压比例低于B组,且多椎板间隙减压比例高于B组,多节段固定比例明显高于B组,差异有统计学意义(P 0.05)。B组1周矢状面Cobb角大于A组,差异有统计学意义(P 0.05);但2组术后1周冠状面Cobb角、JOA评分差异无统计学意义(P0.05)。A组邻近节段退变发生率明显高于B组,差异有统计学意义(P 0.05)。结论后路椎弓根钉内固定、椎管减压、选择性椎间植骨融合术治疗退行性腰椎侧凸时,固定、减压节段越多,术后发生邻近节段退变的概率越大。     

Denis B型胸腰椎爆裂性骨折行后路单节段钛网重建术对邻近节段的影响

目的探讨Denis B型胸腰椎爆裂性骨折行后路单节段钛网重建术对邻近节段的影响。方法 20例Denis B型胸腰椎爆裂性骨折患者行后路单侧椎体次全切除、脊髓270°减压、钛网植骨重建前中柱及椎弓根钉内固定并后路重建术。1年后取出钉棒内固定并继续随访1～3年。末次随访通过动力位X线片、MRI评估邻近节段椎间盘变化情况。结果末次随访时,患者钛网均无松动。有2例患者出现不同程度塌陷,Cobb角有所丢失。所有患者远端椎间盘有不同程度退变,椎间隙未见明显变窄,邻近节段椎间盘退变Pfirrmann分级:Ⅰ级退变13例,Ⅱ级退变5例,Ⅲ级退变1例,Ⅳ级退变1例。结论后路单节段固定钛网重建治疗Denis B型胸腰椎爆裂性骨折加速邻近节段椎间盘退行性变。     

单节段后路椎间融合内固定术对腰椎前凸角度变化的影响

目的探讨L4/L5单节段后路椎间融合器置入椎弓根内固定术对患者腰椎前凸角度变化的影响。方法回顾性随访分析43例L4/L5单节段后路椎间融合器置入配合使用椎弓根内固定术的患者,对患者术前、术后总腰椎前凸角度、L4/L5节段前凸角、骶骨倾斜角进行比较。结果 L4/L5单节段后路椎间融合术后患者总腰椎前凸角度与术前对比平均增加8.4°（P〈0.01）;L4/L5节段前凸角与术前对比平均增加3.5°（P〈0.05）;骶骨倾斜角与术前对比平均增加4.2°（P〈0.05）。结论 L4/L5单节段后路椎间融合器置入椎弓根内固定术可以明显改善患者腰椎前凸角度,对于改善腰椎序列和缓解患者术后腰痛症状以及延缓邻近节段退变均有积极意义。     

后路L4/5融合术后邻椎病发生的危险因素

【摘要】 目的：探讨后路L4/5融合术后邻椎病（adjacent segment disease，ASD）发生的危险因素。方法：回顾性分析2012年9月~2021年9月因后路L4/5融合术后ASD于我院接受翻修手术的26例患者，纳入ASD组；采用1∶2匹配的方法，从同期接受腰椎后路融合手术且末次随访时未发生ASD的患者中，按性别、手术时年龄、手术节段、随访时间匹配52例患者作为对照组。收集两组患者术前、术后3d、末次随访时的影像学资料，在腰椎侧位X线片上测量：腰椎前凸角（lumbar lordosis，LL）、节段性前凸（segmental lordosis，SL）、骶骨倾斜角（sacral slope，SS）和L3/4、L4/5、L5/S1的椎间隙相对高度；在初次术前MRI上，采用Pfirrmann分级对融合节段邻近节段椎间盘退变情况进行评估。将两组患者术前基线资料，术前、术后3d、末次随访时的腰椎影像学资料（包括腰椎矢状位参数和初次术后腰椎矢状位参数矫正值）进行比较，将有差异的参数进行多因素Logistic回归分析，通过受试者工作特征（receiver operating characteristic，ROC）曲线确定独立危险因素对ASD的最佳预测阈值。结果：ASD组与对照组在术前第一诊断、术前邻近节段椎间盘的Pfirrmann分级、合并症情况均无统计学差异（P>0.05）。ASD组患者初次接受手术后5.4±2.3年行二次手术，二次手术融合节段L3/4 16例，L5/S1 10例。两组术前SL、SS以及L4/5、L3/4和L5/S1椎间隙相对高度均无显著性差异（P＞0.05），ASD组患者初次术前LL显著性小于对照组（P=0.031）。初次融合术后3d，ASD组SL和LL显著性小于对照组（P＜0.05）。末次随访时，ASD组SL和LL均显著小于对照组（P<0.001）；ASD组的L3/4椎间隙相对高度明显小于对照组（P=0.002）。两组初次手术各参数的矫正值相比，ASD组的SL相对差值（relative △SL，r△SL）显著性小于对照组（P<0.001），两组间LL相对差值（relative △LL，r△LL）、L4/5椎间隙高度相对差值（relative △disc height，r△DH）、L3/4 r△DH、L5/S1 r△DH均无显著性差异（P>0.05）。以ASD为因变量的多元回归分析结果显示较小的初次r△SL是发生ASD的独立危险因素（OR=0.031，95%置信区间0.005~0.209），其曲线下面积（area under curve，AUC）为0.731（95%置信区间0.615~0.848），最佳预测阈值为-10.5%。结论：后路L4/5融合术中局部曲度纠正不足可能会导致远期邻近节段高度的丢失，是融合术后发生ASD的独立危险因素。     

腰椎后路减压融合内固定术后邻近节段退行性疾病的手术疗效分析

目的 观察不同手术方法治疗腰椎后路减压融合内固定术后邻近节段退行性疾病的临床疗效,通过相关文献分析邻近节段退行性疾病发生原因及手术方式选择。方法 回顾性分析自2013-02—2020-01手术治疗的28例腰椎后路减压融合内固定术后邻近节段腰椎退行性疾病,5例行后路腰椎间融合术,9例行经椎间孔腰椎间融合术,6例行侧路腰椎间融合术,8例行经皮脊柱内镜椎间盘切除术。结果 28例均获得随访,随访时间平均22.5(12～48)个月。随访期间未出现假关节形成、融合器移位或沉降、螺钉断裂、螺钉松动,融合节段均获得骨性融合。术后第3天腰痛VAS评分、腿痛VAS评分、ODI指数较术前降低,术后12个月上述指标较术后第3天降低,差异有统计学意义（P<0.05）。末次随访时骨盆倾斜角、骨盆入射角、骶骨倾斜角与术前比较差异无统计学意义（P>0.05）,而腰椎前凸角较术前增加,差异有统计学意义（P<0.05）。开放手术20例末次随访时改良MacNab标准评定结果：优14例,良5例,可1例。微创手术8例末次随访时改良MacNab标准评定结果：优4例,良3例,差1例。结论 腰椎后路减压融合内固定术...     

显微椎间盘镜下B-Twin椎间融合术治疗腰椎退变失稳型椎间盘突出症

目的探讨后路显微椎间盘镜下可膨胀性椎间融合器B-Twin植入椎间融合术治疗腰椎退变失稳型椎间盘突出症的临床疗效。方法 2005年9月~2008年6月,对32例腰椎退变失稳型椎间盘突出症行后路显微椎间盘镜联合可膨胀性椎间融合器B-Twin植入椎间融合术。手术融合节段：L2/31例,L3/43例,L4/518例,L5/S110例,均为单节段。结果植入2枚B-Twin 23例,单枚9例。术后1周VAS疼痛评分由术前8.7±0.3降至2.3±1.7（t=20.64,P=0.001）。随访时间平均25个月（24~29个月）,植骨融合率采用Suk标准：1年融合率为93.8%（30/32）,2年融合率为96.9%（31/32）,B-Twin椎间融合器无明显下沉。结论后路显微椎间盘镜联合可膨胀性椎间融合器B-Twin植入椎间融合术治疗腰椎退变失稳型椎间盘突出症创伤小,植骨融合率高,临床症状缓解满意。     

腰椎椎间融合术与动态固定术治疗腰椎退行性疾病的临床评价

目的通过比较分析腰椎椎间融合术与动态固定术治疗腰椎退行性疾病的临床疗效和术后并发症,探讨腰椎退行性疾病治疗方法的合理选择。方法 2009年1月～2010年12月,选择32例腰椎退行性疾病（L4/L5）患者,按配对设计分为对照组和治疗组,对照组16例患者均行椎弓根螺钉固定并单枚融合器置入;治疗组16例患者行常规椎板切除减压、髓核摘除和Isobar动态固定。比较观察2组病例的治疗效果、手术时间、出血量、手术并发症等。治疗效果评价采用Oswestry功能障碍指数（Oswestry disability index,ODI）及疼痛视觉模拟量表（visual analogue scale,VAS）评分,手术邻近节段（L3/L4和L5/S1）及腰椎（L2～S1）的活动度（range of motion,ROM）采用过伸过屈动力侧位X线片检查进行评价。结果所有患者均获6～24个月的随访,平均15.8个月。与术前相比,2组患者术后症状均有明显改善,术后ODI及VAS评分与术前相比差异有统计学意义（P〈0.01）;2组手术时间、出血量差异无统计学意义（P〉0.05）;2组均未出现内固定相关并发症;2组术后邻近节段（L3/L4和L5/S1）的ROM与术前相比差异无统计学意义（P〉0.05）。腰椎（L2～S1）的ROM,融合组较术前显著下降,差异有统计学意义（P〈0.05）;而动态固定组较术前有所增加,但差异无统计学意义（P﹥0.05）。结论腰椎椎间融合术与Isobar动态固定术治疗单节段腰椎退变性疾病均可取得满意的短期临床疗效,但理论上动态固定技术内固定失败的风险高于椎间融合术,故采用动态固定技术治疗腰椎退变性疾病应慎重。     

开窗减压椎间植骨融合内固定治疗退变性腰椎不稳

[目的]探讨开窗减压、椎间植骨融合(PLIF)内固定治疗老年退变性腰椎不稳.[方法]81例临床病人,男38例,女43例;年龄47～71岁,平均62岁;病变部位:L2、3间隙2例,L3、4间隙63例,L4、5间隙33例,L5S1间隙5例;2节段椎间融合21例,3节段椎间融合15例,4节段椎间融合2例;伴椎体Ⅰ度滑脱26例,伴有>15°侧凸的4例.术前常规摄腰椎正侧位、双斜位、腰椎过伸过屈动力位片、CT及MRI,了解椎管狭窄及椎体不稳程度;经腰椎后路行椎弓根钉棒系统内固定、开窗椎管减压、自体骨及Cage椎间植骨融合手术治疗,术中行撑开、提拉,将减压的自体椎板骨质修整,颗粒状碎骨填充于Cage,块状较大的骨块植入椎间隙,术后1周带腰围或佩戴支具下床活动.[结果]本组随访时间2～4年,术后均行X线片复查,随访X线片显示椎间植骨融合良好,椎体复位无丢失,螺钉无折断和松动.手术前、后椎体滑移距离和ODI指数两项参数的配对比较差异具有显著性.[结论]椎弓根钉棒系统内固定、开窗椎管彻底减压、自体骨混合Cage椎间植骨融合是治疗退变性腰椎不稳的一种有效手术方法.     

腰椎单节段固定融合术后上位相邻节段退变及其与临床疗效的关系

目的:探讨腰椎单节段固定融合术后上位相邻节段退变及其与临床效果的关系,分析退变的相关因素。方法:回顾性分析2004年10月～2009年5月采用后路单节段椎弓根螺钉固定并椎体间cage植骨融合术治疗的49例L4/5退变性失稳患者,男22例,女27例,年龄28～72岁(平均53.4岁)。所有患者术前均行骨密度检测。在X线片上测量固定节段及其上位相邻节段椎间盘高度、椎间隙动态角度变化、椎体滑移距离以及固定节段和腰椎前凸角、腰骶关节角,并通过JOA评分及腰功能障碍指数(ODI)评价临床效果。根据末次随访时上位相邻节段有无影像学退变,分为退变组与非退变组,比较两组间临床效果及影像学测量结果。结果:随访时间为13～52个月,平均为29.3个月,所有患者术后均无神经损害加重症状。末次随访时11例患者(22%)出现上位相邻节段影像学退变。两组患者手术时的平均年龄有显著性差异(P<0.05);术前骨密度、腰椎前凸角、腰骶关节角、L4/5前凸角和椎体间滑移距离均无显著性差异(P>0.05);末次随访时L3/4椎体间滑移距离、L3/4椎间盘高度以及椎间隙动态成角变化值均存在显著性差异(P<0.05),ODI和JOA评分改善率无显著性差异(P>0.05)。患者年龄与末次随访时固定上位相邻节段椎间盘高度、椎间隙动态成角、椎体间滑移距离变化值存在正相关性,相关系数分别为0.353、0.521、0.472,余测量指标与固定上位相邻节段影像学指标变化均无显著相关性。结论:单节段腰椎固定融合术后上位相邻节段影像学退变与临床效果之间无显著相关性。此退变与患者年龄相关,而与骨密度和术前腰椎影像学测量指标无显著相关性。     

The development of discopathy in lumbar discs adjacent to a lumbar anterior interbody spondylodesis. A retrospective matched-pair study with a postoperative follow-up of 16 years.

Of 46 patients who underwent a lumbar or lumbo-sacral anterior interbody fusion at one or two levels, 16 were available for a follow-up of 16-20 years. The indications for operation were instability, degenerative disc disease, pseudarthrosis of a posterior fusion, and spondylolisthesis. Preoperative roentgenograms were compared with those made at follow-up 16 years (or more) later. In only a minority of patients was discopathy or instability found. The roentgenographic findings of the operated patients at a follow-up of at least 16 years were compared with those of a group of age- and sex-matched controls not previously treated for backache. We found that most degenerative changes of the adjacent discs occurred at a rate nearly similar to that in the corresponding levels of the controls. These results may suggest that lumbar anterior interbody spondylodesis does not accelerate the development of degenerative changes in adjacent discs.     

腰椎后路椎间植骨融合内固定术后邻近节段椎间盘退行性改变生物力学特点的有限元分析

目的采用有限元方法分析腰椎后路椎间植骨融合内固定术后邻近节段椎间盘退变的生物力学特点。方法采集1名正常成人L_3~5的CT扫描数据,经有限元软件建立正常腰椎L_3~5模型(正常模型)、L_4、5椎弓根钉内固定模型(PSF),以及L_4、5全椎板减压、椎间cage融合、椎弓根钉内固定模型(PSF+PLIF)。比较3个模型在模拟人体腰椎前屈、后伸、左侧弯、右侧弯、左轴向旋转、右轴向旋转时L_3、4椎间盘膨出与内陷最大值,以及各方向L_3、4纤维环应力峰值。结果 PSF+PLIF模型与PSF模型L_3、4椎间盘膨出、内陷最大值较正常模型明显增大,且PSF+PLIF模型较PSF模型大,差异有统计学意义(P <0.05)。PSF+PLIF模型与PSF模型左侧弯、右侧弯、左轴向旋转、右轴向旋转时L_3、4的纤维环应力峰值增幅明显大于Model模型,且PSF+PLIF模型增幅大于PSF模型,差异有统计学意义(P <0.05)。结论腰椎后路椎间植骨融合内固定术引起邻近节段椎间盘生物力学改变是加重邻近节段椎间盘退行性改变程度的重要因素。     

Long-term follow-up study of posterior lumbar interbody fusion.

To see whether degenerative changes of the adjacent disks are accelerated by fixation of a lumbar segment, 48 patients who had undergone posterior lumbar interbody fusion (PLIF) more than 5 years previously were investigated radiographically and clinically. Narrowing of disk spaces was observed in 31% of the subjects, but it usually occurred at levels proximal to the fusion. The incidence of adjacent disk narrowing was not significantly higher after PLIF, compared with reports on degenerative changes of lumbar disks with aging. Some subjects showed narrowing of disks that were not adjacent to the fused level, suggesting that individual predisposition played a role in disk narrowing. Instability was not seen in any of the subjects. New development or elongation of the traction spurs at adjacent segments occurred at the disks proximal to the fusion. The clinical results were generally satisfactory, despite progression of degenerative changes on radiographs.     

Quantitative MRI analysis of the surface area, signal intensity and MRI index of the central bright area for the evaluation of early adjacent disc degeneration after lumbar fusion

Purpose

The aim of this study was to evaluate early ASD at short-term follow-up in fused and unoperated patients with degenerative disc disease, using quantitative magnetic resonance imaging (MRI) analysis of the area, signal intensity and their product, i.e., MRI index of the central bright area of the disc as well as measures of intervertebral disc height and Pfirrmann grading scale. The further purpose was to determine whether fusion accelerates ASD compared with non-surgical treatment in short-term follow-up.

Methods

One hundred and eight chronic low back patients diagnosed as L4/L5 degeneration undertook either one-level instrumented posterior lumbar interbody fusion or conservative treatment. They were followed up for about 1?year. Finally 46 fused and 45 conservatively treated patients with MRI follow-up were included. Pre- and post-treatment MRIs were compared to determine the progression of disc degeneration at the two cranial adjacent segments.

Results

The area, signal intensity and MRI index of the central bright area of the adjacent discs decreased in the operated and unoperated groups from pre-treatment to follow-up, except for an insignificant decrease of signal intensity at the second adjacent segment in the unoperated group. The changes in these parameters were statistically greater at the first than the second adjacent segment in the fused group, but not in the unoperated group. And the changes in the fused group were more pronounced than those at both neighbouring levels in the unoperated group. However, the Pfirrmann grading scale and intervertebral disc height did not detect any changes at adjacent discs in either group.

Conclusions

Decrease in the parameters of quantitative MRI analysis indicated early degeneration at discs adjacent to lumbar spinal fusion. Fusion had an independent effect on the natural history of ASD during short-term follow-up. Continued longitudinal follow-up is required to determine whether these MRI changes lead to pathologic changes.     

Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion

Adjacent segment degeneration following lumbar spine fusion remains a widely acknowledged problem, but there is insufficient knowledge regarding the factors that contribute to its occurrence. The aim of this study is to analyse the relationship between abnormal sagittal plane configuration of the lumbar spine and the development of adjacent segment degeneration. Eighty-three consecutive patients who underwent lumbar fusion for degenerative disc disease were reviewed retrospectively. Patients with spondylolytic spondylolisthesis and degenerative scoliosis were not included in this study. Mean follow-up period was 5 years. Results were analysed to determine the association between abnormal sagittal configuration and post operative adjacent segment degeneration. Thirty-one out of 83 patients (36.1%) showed radiographic evidence of adjacent segment degeneration. Patients with normal C7 plumb line and normal sacral inclination in the immediate post operative radiographs had the lowest incidence of adjacent level change compared with patients who had abnormality in one or both of these parameters. The difference was statistically significant (P<0.02). There was no statistically significant difference in the incidence of adjacent level degeneration between male and female patients; between posterior fusion alone and combined posterolateral and posterior interbody fusions; and between fusions extending down to the sacrum and fusions stopping short of the sacrum. It was concluded was that normality of sacral inclination is an important parameter for minimizing the incidence of adjacent level degeneration. Retrolisthesis was the most common type of adjacent segment change. Patients with post operative sagittal plane abnormalities should preferably be followed-up for at least 5 years to detect adjacent level changes.     

DIAPASON系统治疗腰椎管狭窄症的近期疗效

目的探讨用DIAPASON系统治疗退变性腰椎管狭窄的近期治疗效果。方法应用椎板减压、神经根松解、椎间植骨融合、DIAPASON系统固定治疗退变性腰椎管狭窄患者20例。手术节段:L4~5节段10例,L5~S1节段6例,L4~5合并L5~S1者4例。结果20例手术全部成功,术后无感染及内固定失败等并发症,随访6~18个月,8例患者腰腿痛消失,11例症状改善,1例无变化。17例行走功能改善。3例有泌尿功能障碍的患者中2例症状改善,1例无改变。结论后路行椎管减压、神经根松解、应用DIAPASON系统内固定、椎间植骨融合治疗退变性腰椎管狭窄症近期疗效满意。     

Kinematic evaluation of the adjacent segments after lumbar instrumented surgery: a comparison between rigid fusion and dynamic non-fusion stabilization

The aim of the current study was to evaluate changes in lumbar kinematics after lumbar monosegmental instrumented surgery with rigid fusion and dynamic non-fusion stabilization. A total of 77 lumbar spinal stenosis patients with L4 degenerative spondylolisthesis underwent L4–5 monosegmental posterior instrumented surgery. Of these, 36 patients were treated with rigid fusion (transforaminal lumbar interbody fusion) and 41 with dynamic stabilization [segmental spinal correction system (SSCS)]. Lumbar kinematics was evaluated with functional radiographs preoperatively and at final follow-up postoperatively. We defined the contribution of each segmental mobility to the total lumbar mobility as the percent segmental mobility [(sagittal angular motion of each segment in degrees)/(total sagittal angular motion in degrees) × 100]. Magnetic resonance imaging was performed on all patients preoperatively and at final follow-up postoperatively. The discs were classified into five grades based on the previously reported system. We defined the progress of disc degeneration as (grade at final follow-up) − (grade at preoperatively). No significant kinematical differences were shown at any of the lumbar segments preoperatively; however, significant differences were observed at the L2–3, L4–5, and L5–S1 segments postoperatively between the groups. At final follow-up, all of the lumbar segments with rigid fusion demonstrated significantly greater disc degeneration than those with dynamic stabilization. Our results suggest that the SSCS preserved 14% of the kinematical operations at the instrumented segment. The SSCS may prevent excessive effects on adjacent segmental kinematics and may prevent the incidence of adjacent segment disorder.