Back to Search
Start Over
Transforaminal lumbar interbody fusion using unilateral pedicle screw fixation plus contralateral translaminar facet screw fixation in lumbar degenerative diseases
- Source :
- Indian Journal of Orthopaedics, Vol 48, Iss 4, Pp 374-379 (2014), Indian Journal of Orthopaedics
- Publication Year :
- 2014
- Publisher :
- Springer Science and Business Media LLC, 2014.
-
Abstract
- Background: Transforaminal lumbar interbody fusion (TLIF) has been used in lumbar degenerative diseases. Some researchers have applied unilateral fixation in TLIF to reduce operational trauma without compromising the clinical outcome, but it is always suspected biomechanically unstable. The supplementary contralateral translaminar facet screw (cTLFS) seemed to be able to overcome the inherent drawbacks of unilateral pedicle screw (uPS) fixation theoretically. This study evaluates the safety, feasibility and efficacy of TLIF using uPS with cTLFS fixation in the treatment of lumbar degenerative diseases (LDD). Materials and Methods: 50 patients (29 male) underwent the aforementioned surgical technique for their LDD between December 2009 and April 2012. The results were evaluated based on visual analogue scale (VAS) of the leg and back, Japanese Orthopedic Association (JOA) score and Oswestry Disability Index (ODI) were recorded. The radiographic examinations in form of X-ray, computed tomography (CT) or magnetic resonance imaging was done preoperatively and 1 week, 3 months, 6 months, 12 months and 24 months postoperatively. The student t-test was used for comparison between the preoperative values and postoperative counterparts. P < 0.05 was considered to be statistically significant. Results: Among 50 patients, 22 received one level fusion and 28 two level′s, with corresponding operation time and estimated blood loss being approximately 90 min, 150 ml and 120 min, 200 ml, respectively. No severe complications happened perioperatively. The mean VAS (back, leg) scores dropped from (7.6, 7.5) preoperatively to (2.1, 0.6) at 12 months′ followup, ODI from 49.1 preoperatively to 5.6 and JOA score raised from 10.6 preoperatively to 28.5, all P < 0.001, suggesting of good clinical outcome. From the three-dimensional reconstructed CT, 62 out of 70 segments displayed solid fusion with fusion rate of 88.6% at 12 months postoperatively. Conclusions: TLIF using uPS fixation plus cTLFS fixation is a safe, feasible and effective technique in the treatment of one or two level lumbar degenerative diseases short termly.
- Subjects :
- medicine.medical_specialty
Visual analogue scale
translaminar facet screw Mesh terms: Lumbar vertebra
Lumbar vertebrae
mesh:Lumbar vertebra
mesh:bone screw
Fixation (surgical)
Degenerative disease
Lumbar
lcsh:Orthopedic surgery
transforaminal lumbar interbody fusion
medicine
degenerative disease
Orthopedics and Sports Medicine
Lumbar degenerative diseases
translaminar facet screw
medicine.diagnostic_test
mesh:degenerative disease
business.industry
Magnetic resonance imaging
medicine.disease
Surgery
Oswestry Disability Index
lcsh:RD701-811
medicine.anatomical_structure
Orthopedic surgery
Original Article
bone screw
business
Subjects
Details
- ISSN :
- 19983727 and 00195413
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- Indian Journal of Orthopaedics
- Accession number :
- edsair.doi.dedup.....6ab6b992499ad9e11b6daa1e153d4d62