Comparison between single anterior and single posterior approaches of debridement interbody fusion and fixation for the treatment of mono-segment lumbar spine tuberculosis

Abstract Purpose To compare the efficacy of single anterior and single posterior approach of debridement, interbody fusion, and fixation for the treatment of mono-segment lumbar spine tuberculosis (TB) patients. Methods Eighty-seven patients with mono-segment lumbar TB who underwent debridement, interbody fusion, and fixation through either single anterior (Group A) or single posterior approach (Group B) from January 2007 to January 2017 were enrolled in this study. The duration of the operation, blood loss, complication rate, visual analog scale (VAS), Oswestry disability index (ODI), Frankel scale, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), kyphosis angle, correction rate, correction loss, and time taken for bone graft fusion were compared between the groups. Results The average period of follow-up was 34.3 ± 9.5 months (24–56 months). No significant differences were observed between patients in Group A and patients in Group B in terms of gender, age, body mass index (BMI), duration of illness and preoperative evaluative indices (P > 0.05). The mean operation time and blood loss was significantly higher in Group A (P = 0.000), along with a slightly higher rate of complications compared with Group B (P = 0.848). The VAS, ODI and Frankel scale scores showed significant improvement in both groups (P = 0.000), along with the ESR, CRP and kyphosis indices (P = 0.000), which were similar in both groups at the final follow-up. Conclusion Both single anterior and single posterior approaches of debridement, interbody fusion and fixation are effective for mono-segment lumbar TB patients, although the single posterior approach is of a shorter duration and results in less blood loss.

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Surgery for thoracolumbar junction (T12-L1) tuberculosis a multicentre, retrospective study

10.21203/rs.2.13914/v1 ◽

2019 ◽

Author(s):

Yanping Zeng ◽

Peng Cheng ◽

Jiulin Tan ◽

Zhilin Li ◽

Yuan Chen ◽

...

Keyword(s):

Blood Loss ◽

Posterior Approach ◽

Spinal Tuberculosis ◽

Surgical Techniques ◽

Operation Time ◽

Thoracolumbar Junction ◽

Group A ◽

The Mean ◽

Group B ◽

Approach Group

Abstract Purpose A multicentre, retrospective study was conducted to evaluate the safety and efficacy of different surgical techniques for thoracolumbar junction (T12-L1) tuberculosis. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 257) from January 2005 to January 2015 were collected and reviewed. A total of 45 patients were operated on by an anterior approach (Group A), 52 by a combined anterior and posterior approach (Group B) and 160 by a posterior approach (Group C). Anti-tuberculosis therapy was performed both before and after surgery. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Results All three surgical approaches achieved bone fusion, pain relief and neurological recovery. The mean loss of correction in group A at last follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time and blood loss in group B were greater than in groups A and C. Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only approach is superior to the anterior-only approach in the correction of kyphosis and maintenance of spinal stability. The posterior-only approach is recommended because it achieves the same efficacy as the anterior-only or combined approach but with shorter operation times, less trauma and less blood loss. Keywords Spinal tuberculosis; Thoracolumbar junction; Three approaches.

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A Modified Method to Treat Severe Asymptomatic Pre-existing Degeneration of Adjacent Segment: A Retrospective Case-Control Study

10.21203/rs.3.rs-70798/v1 ◽

2020 ◽

Author(s):

Xinliang Zhang ◽

Jinwen Zhu ◽

Yibing Li ◽

Dingjun Hao ◽

Wenjie Gao

Keyword(s):

Interbody Fusion ◽

Operation Time ◽

Adjacent Segment Degeneration ◽

Adjacent Segment ◽

Retrospective Case ◽

Modified Method ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background: Pre-existing degeneration of adjacent segment is an important risk factor for adjacent segment degeneration (ASD), but limited and controversial studies have addressed its management.Methods: Patients with symptomatic degeneration of the L5/S1 segment warranting surgical interference and severe asymptomatic degeneration of the L4/5 segment were retrospectively analyzed. Among them, those who underwent interbody fusion in the causative (L5/S1) segment and distraction of the intervertebral space and facet fusion in the adjacent L4/5 segment were included as Group A (n=103). Patients who underwent interbody fusion in both L5/S1 and L4/5 segments were included as Group B (n=81). Clinical and radiographic outcomes were evaluated.Results: Mean follow-up was 58.5 months (range, 48-75 m). No significant difference in clinical outcomes or the incidence of adjacent segment degeneration in L3/4 segment was found between Groups A and B. Compared with Group B, less bleeding (315±84 vs. 532±105 ml), shorter operation time (107±34 vs. 158±55 min) and lower costs (13,830±2640 vs. 16,020±3380 US$) were found in Group A (P<0.05). In Group A, disc height ratio (DHR) of L4/5 segment was significantly increased from preoperative value of 0.40±0.13 to last follow-up value of 0.53±0.18 (P<0.05), while the degree of canal stenosis (DCS) was decreased from preoperative value of 34.3±11.2% to last follow-up value of 15.9±9.3% (P<0.05). Conclusions: This modified method could be effective in treating severe asymptomatic pre-existing degeneration of adjacent segment in lumbar spine.

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A Comparison of the Bridge-type ROI-C Interbody Fusion Cage System and Titanium Mesh Graft With Titanium Plate Fixation in 2-level Anterior Cervical Discectomy and Fusion With Plating and Cage System: A Retrospective Study

10.21203/rs.3.rs-48049/v1 ◽

2020 ◽

Author(s):

Shuangjun He ◽

Zhangzhe Zhou ◽

Xiaofeng Shao ◽

Changhao Zhang ◽

Xinfeng Zhou ◽

...

Keyword(s):

Interbody Fusion ◽

Operation Time ◽

Fusion Rate ◽

Cage System ◽

Significant Difference ◽

Group A ◽

Bridge Type ◽

Group B ◽

Fusion Cage

Abstract Objective To explore the clinical efficacy and radioactive results of the bridge-type ROI-C interbody fusion cage (ROI-C) and anterior cervical discectomy and fusion with plating and cage system (ACDF) for cervical spondylopathy. Methods From January 2014 to January 2018, 45 patients undergoing ACDF were retrospectively analyzed, including 24 cases of ROI-C (group A) and 21 cases of ACDF (group B). The operation time, blood loss, Neck Disability Index (NDI), Japanese Orthopaedic Association score (JOA), postoperative complications, imaging results including cervical Cobb angle and fusion were compared between groups. Results All patients were successfully treated with surgery, and no cerebrospinal fluid leakage, esophageal fistula, or hoarseness occurred after surgery. The operation time and blood loss in group A were lower than those in group B (P < 0.05). During the follow-up period, JOA score increased and NDI score decreased after operation (P < 0.05), but there was no significant difference between the groups (P > 0.05). The incidence of dysphagia in group A was lower than that in group B at 1 month and 3 months after operation (P < 0.05), but the final follow-up results showed that there was no significant difference in the incidence of dysphagia between the two groups (P > 0.05). In group A, the fusion rate was 83.3% 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 12.5%. In group B, the fusion rate was 85.7% 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 23.8%. Conclusion Both ROI-C and ACDF can achieve satisfactory results, but ROI-C has shorter operation time, less bleeding and lower incidence of dysphagia in the short term.

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A modified method to treat severe asymptomatic pre‐existing degeneration of adjacent segment: a retrospective case‐control study

BMC Surgery ◽

10.1186/s12893-021-01163-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xinliang Zhang ◽

Jinwen Zhu ◽

Yibing Li ◽

Dingjun Hao ◽

Wenjie Gao

Keyword(s):

Interbody Fusion ◽

Operation Time ◽

Adjacent Segment Degeneration ◽

Adjacent Segment ◽

Retrospective Case ◽

Modified Method ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background Pre-existing degeneration of adjacent segment is an important risk factor for adjacent-segment degeneration (ASD), but only limited and controversial studies have addressed its management. Methods We retrospectively analyzed patients with symptomatic degeneration of the L5/S1 segment warranting surgical interference and severe asymptomatic degeneration of the L4/5 segment. Of these patients, those who underwent interbody fusion of the causative (L5/S1) segment and distraction of the intervertebral space and facet fusion of the adjacent L4/5 segment were included in Group A (n = 103), while those who underwent interbody fusion of both the L5/S1 and L4/5 segments were included in Group B (n = 81). Clinical and radiographic outcomes were evaluated. Results Mean follow-up time was 58.5 months (range, 48–75 months). We found no significant difference in clinical outcomes or incidence of ASD in the L3/4 segment between Groups A and B. Compared with Group B, Group A experienced less bleeding (315 ± 84 ml vs. 532 ± 105 ml), shorter operation time (107 ± 34 min vs. 158 ± 55 min) and lower costs (US $13,830 ± $2640 vs. US $16,020 ± $3380; P < 0.05). In Group A, the disc height ratio (DHR) of the L4/5 segment was significantly increased from a preoperative value of 0.40 ± 0.13 to a last–follow-up value of 0.53 ± 0.18 (P < 0.05), while the degree of canal stenosis (DCS) was decreased from a preoperative value of 34.3 ± 11.2% to a last–follow-up value of 15.9 ± 9.3 % (P < 0.05). Conclusions This modified method could be effective in treating severe asymptomatic pre-existing degeneration of adjacent segment in the lumbar spine.

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A comparison of the bridge-type ROI-C interbody fusion cage system and ACDF with plating and cage system in 2-level anterior cervical discectomy and fusion: A retrospective study

10.21203/rs.3.rs-48049/v2 ◽

2021 ◽

Author(s):

Shuangjun He ◽

Zhangzhe Zhou ◽

Xiaofeng Shao ◽

Changhao Zhang ◽

Xinfeng Zhou ◽

...

Keyword(s):

Interbody Fusion ◽

Operation Time ◽

Fusion Rate ◽

Postoperative Dysphagia ◽

Cage System ◽

Group A ◽

Bridge Type ◽

Group B ◽

Fusion Cage

Abstract Objective: A study was conducted to explore the clinical efficacy and radioactive results of the bridge-type ROI-C interbody fusion cage (ROI-C) and anterior cervical discectomy and fusion with plating and cage system (ACDF) for cervical spondylopathy.Methods: From January 2014 to January 2018, 45 patients who underwent operations were retrospectively analyzed, including 24 cases of ROI-C (group A) and 21 cases of ACDF (group B). The operation time, blood loss, Neck Disability Index (NDI), Japanese Orthopaedic Association score (JOA), postoperative complications, imaging results including cervical Cobb angle, and fusion were compared between groups.Results: All patients were successfully treated with surgery. No cerebrospinal fluid leakage, esophageal fistula, or hoarseness occurred after the surgery. The operation time and blood loss in group A were lower than those in group B (P<0.05). During the follow-up period, JOA score increased and NDI score decreased after the operation (P<0.05), but no significant difference was found between the groups (P>0.05). In group A, the incidence of postoperative dysphagia was 12.5%, which returned to normal after 1 month. In group B, the incidence of postoperative dysphagia was 38.1%, which was 19% after 1 month and 4.8% at the final follow-up. In group A, the fusion rate was 83.3% at 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 12.5%. In group B, the fusion rate was 85.7% at 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 23.8%.Conclusion: Both ROI-C and ACDF achieved satisfactory results, but ROI-C had a shorter operation time, less bleeding, and lower incidence of dysphagia in the short term.

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Transpseudarthrosis Osteotomy with Interbody Fusion for Kyphotic Spinal Pseudarthrosis in Ankylosing Spondylitis by a Single Posterior Approach: A Retrospective Study and a Brief Relevant Literature Review

BioMed Research International ◽

10.1155/2017/4079849 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Erzhu Yang ◽

Liangliang Cao ◽

Guowang Zhang ◽

Xiaofeng Lian ◽

Jianguang Xu

Keyword(s):

Ankylosing Spondylitis ◽

Blood Loss ◽

Posterior Approach ◽

Interbody Fusion ◽

Operative Time ◽

Relevant Literature ◽

Clinical Results ◽

Average Operative Time ◽

Single Posterior Approach

Objective. To explore the safety and efficacy of transpseudarthrosis osteotomy with interbody fusion in the treatment of Ankylosing Spondylitis (AS) patients with kyphotic spinal pseudarthrosis by a single posterior approach. Methods. Twelve consecutive patients with spinal pseudarthrosis underwent transpseudarthrosis osteotomy and interbody fusion with a polyetheretherketone (PEEK) cage by a single posterior approach. The operative time, intraoperative blood loss, and complications were recorded. Radiographic and clinical results were assessed preoperatively and at the final follow-up. Results. The average operative time was 201.9 min and the mean blood loss was 817.5 ml. The visual analogue scale (VAS) improved significantly from 6.7 preoperatively to 1.1 at the final follow-up. The average correction of the segmental kyphosis at the level of the pseudarthrosis was 22.3°. Bony fusion was achieved in all patients, and there was no obvious loss of correction at follow-up. Conclusion. Transpseudarthrosis osteotomy at the level of the pseudarthrosis can be safely performed and surgical repair of pseudarthrosis with interbody fusion by a single posterior approach was feasible.

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A Comparison Of The Bridge-Type Roi-c Interbody Fusion Cage System And Titanium Mesh Graft With Titanium Plate Fixation In 2-Level Anterior Cervical Discectomy And Fusion With Plating And Cage System: A Retrospective Study

10.21203/rs.3.rs-41918/v1 ◽

2020 ◽

Author(s):

Shuangjun He ◽

Zhangzhe Zhou ◽

Xiaofeng Shao ◽

Changhao Zhang ◽

Xinfeng Zhou ◽

...

Keyword(s):

Interbody Fusion ◽

Operation Time ◽

Fusion Rate ◽

Cage System ◽

Significant Difference ◽

Group A ◽

Bridge Type ◽

Group B ◽

Fusion Cage

Abstract Objective: To explore the clinical efficacy and radioactive results of the bridge-type ROI-C interbody fusion cage (ROI-C) and anterior cervical discectomy and fusion with plating and cage system (ACDF) for cervical spondylopathy.Methods: From January 2014 to January 2018, 45 patients undergoing ACDF were retrospectively analyzed, including 24 cases of ROI-C (group A) and 21 cases of ACDF (group B). The operation time, blood loss, Neck Disability Index (NDI), Japanese Orthopaedic Association score (JOA), postoperative complications, imaging results including cervical Cobb angle and fusion were compared between groups.Results: All patients were successfully treated with surgery, and no cerebrospinal fluid leakage, esophageal fistula, or hoarseness occurred after surgery. The operation time and blood loss in group A were lower than those in group B (P<0.05). During the follow-up period, JOA score increased and NDI score decreased after operation (P<0.05), but there was no significant difference between the groups (P>0.05). The incidence of dysphagia in group A was lower than that in group B at 1 month and 3 months after operation (P<0.05), but the final follow-up results showed that there was no significant difference in the incidence of dysphagia between the two groups (P>0.05). In group A, the fusion rate was 83.3% 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 12.5%. In group B, the fusion rate was 85.7% 3 months after surgery and 100% at the last follow-up. The rate of adjacent level ossification development was 23.8%.Conclusion: Both ROI-C and ACDF can achieve satisfactory results, but ROI-C has shorter operation time, less bleeding and lower incidence of dysphagia in the short term.

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Single posterior debridement, interbody fusion, and fixation on patients with continuous multivertebral lumbar spine tuberculosis (CMLSTB)

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03628-0 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Weihong Long ◽

Liqun Gong ◽

Yaqing Cui ◽

Jie Qi ◽

Dapeng Duan ◽

...

Keyword(s):

Lumbar Spine ◽

Interbody Fusion ◽

Operation Time ◽

Cure Rate ◽

Spine Tuberculosis ◽

Cobb’S Angle ◽

Perioperative Complication ◽

The Mean ◽

Posterior Debridement

Abstract Background Patients with continuous multi-vertebral lumbar spine tuberculosis (CMLSTB) were subjected to single posterior debridement, interbody fusion, and fixation to explore their clinical outcomes. Methods Sixty-seven CMLSTB patients who underwent single posterior debridement interbody fusion and fixation between January 2008 to December 2017 were studied. The operation time, blood loss, perioperative complication rate, cure rate, Visual Analog Scale (VAS), Oswetry disability index (ODI), Japanese Orthopedic Association (JOA), Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle and time of interbody fusion were analyzed to understand their therapeutic effects on CMLSTB patients. Results The patients were followed up for 20–48 months, with a mean of 24.3 months. The mean operation time was 215.5 min (range, 120–280 min), whereas 818.0 ml of blood was lost (range, 400–1500 ml) with a perioperative complication rate of 6.0% and a cure rate of 95.5%. During the last phase of follow-up, the mean preoperative VAS score (5.7) and ODI (72.0%) decreased significantly to 1.4 (t = 31.4, P<0.01) and 8.4% (t = 48.4, P<0.01), respectively. Alternatively, the mean preoperative ESR and CRP (74.7 mm /h and 69.3 mg/L, respectively) decreased to average values (tESR = 39.7, PESR<0.001; tCRP = 50.2, PCRP<0.001), while the JOA score (13.9) significantly increased to 23.0 (t = − 11.6, P<0.01). The preoperative kyphotic Cobb’s angle (20.5°) decreased to 4.8° after the operation (t = 14.0, P<0.01); however, the kyphotic correction remained intact at the time of follow-up (t = − 0.476, P = 0.635). Furthermore, the mean of interbody fusion time was identified to be 8.8 months (range, 6–16 months). Conclusion Single posterior debridement, interbody fusion, and fixation may be one of the surgical choices for the treatment of CMLSTB patients.

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A New Method to Treat Severe Asymptomatic Pre-existing Degeneration of Adjacent Segment: a Retrospective Case-control Study

10.21203/rs.2.12097/v1 ◽

2019 ◽

Author(s):

Wenjie Gao ◽

Xinliang Zhang ◽

Jinwen Zhu ◽

Zhen Chang ◽

Yibing Li ◽

...

Keyword(s):

Interbody Fusion ◽

Operation Time ◽

Adjacent Segment Degeneration ◽

New Method ◽

Adjacent Segment ◽

Retrospective Case ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background Pre-existing degeneration of adjacent segment is an important risk factor for adjacent segment degeneration (ASD), but limited and controversial studies have addressed its management. Methods Patients with symptomatic degeneration of the L5/S1 segment warranting surgical interference and severe asymptomatic degeneration of the L4/5 segment were retrospectively analyzed. Among them, those who underwent interbody fusion in the causative (L5/S1) segment and distraction of the intervertebral space and facet fusion in the adjacent L4/5 segment were included as Group A (n=103). Patients who underwent interbody fusion in both L5/S1 and L4/5 segments were included as Group B (n=81). Clinical and radiographic outcomes were evaluated. Results Mean follow-up was 58.5 months (range, 48-75 m). No significant difference in clinical outcomes or the incidence of adjacent segment degeneration in L3/4 segment was found between Groups A and B. Compared with Group B, less bleeding (315±84 vs. 532±105 ml), shorter operation time (107±34 vs. 158±55 min) and lower costs (13,830±2640 vs. 16,020±3380 US$) were found in Group A (P<0.05). In Group A, disc height ratio (DHR) of L4/5 segment was significantly increased from preoperative value of 0.40±0.13 to last follow-up value of 0.53±0.18 (P<0.05), while the degree of canal stenosis (DCS) was decreased from preoperative value of 34.3±11.2% to last follow-up value of 15.9±9.3% (P<0.05). Conclusions This new method could be effective in treating severe asymptomatic pre-existing degeneration of adjacent segment in lumbar spine.

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