Transforaminal interbody fusion of the lumbar spine - unilateral approach with contralateral percutaneous transfacet-tranpedicular screw fixation is it enough to secure positive outcome of minimal approach fusion?

2015 ◽  
Vol 15 (3) ◽  
pp. S75-S76
Author(s):  
Andrew Wojcik ◽  
Petros Bountogannis ◽  
Zaid Sharif
Keyword(s):  
Lumbar Spine ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Positive Outcome ◽  
Unilateral Approach ◽  
Transforaminal Interbody Fusion

scholarly journals Unilateral versus bilateral Pedicle Screw Fixation associated with interbody fusion in degenerative Lumbar spine diseases

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E E A Emara ◽  
S H Morad ◽  
A R Farghaly ◽  
O E Ahmed ◽  
M K Khalil
Keyword(s):  
Lumbar Spine ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Operation Time ◽  
Fusion Rate ◽  
Pedicle Screw Fixation ◽  
Bilateral Group ◽  
Significant Difference

Abstract Background Lumbar interbody fusion is a recognized surgical technique in treatment of degenerative lumbar instability. Interbody fusion supplemented with pedicle screw fixation has several advantages over posterolateral fusion and has been advocated to improve fusion rates and clinical outcomes. Interbody fusion places the bone graft in the loadbearing position of the anterior and middle spinal columns thereby enhancing the potential for fusion. In addition, the interbody space has more vascularity than the posterolateral space, also increasing the potential for a solid fusion mass to form. Aim of the Work to assess safety and efficacy of unilateral pedicle screw fixation associated with interbody fusion in Lumbar spine degenerative diseases and to evaluate and compare outcomes of unilateral versus bilateral pedicle screw fixation associated with interbody fusion in lumbar spine degenerative diseases, as regard the operation time, bleeding, postoperative stay, cost, and the clinical and biomechanical results. Material & Methods This observational prospective comparative study of the 2 groups who were operated either unilateral (Group A /25 patients) or bilateral (Group B/25 patients) pedicle screw fixation with interbody fusion was done. Patients were followed up for 1, 6, 12 months. This study occurred at Ain Shams University hospitals. Results No differences were observed between the two groups with respect to demographic data. The patients of the two groups had significant improvement in functional outcome compared to preoperatively, except in early postoperative VAS back and ODI in unilateral group which is better than bilateral group. However, no significant difference noticed in the further follow up. There was no significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. There was significantly less blood loss, shorter postoperative pain killer use and significantly shorter operation time in the unilateral PS fixation group as compared with the bilateral PS fixation group in our study. Conclusion Our study suggested TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation. Unilateral PS fixation may significantly reduce the intraoperative blood loss and shorten the operation time, somewhat improve the clinical outcome scores of ODI and VAS Back without significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. BPSF with TLIF likely causes more degeneration at the cranial adjacent segment compared with UPSF techniques. However, the long-term follow up is required to demonstrate the impact of these findings.

scholarly journals The Hardware Failure and Correction Loss of Short-segment Pedicle Screw Fixation Combined With Transforaminal Interbody Fusion in Treatment of Unstable Thoracolumbar Burst Fracture: Retrospective Study in Vietnam

2021 ◽  
Author(s):  
Ngoc Quyen Nguyen ◽  
Trong Hau Phan ◽  
Van Hong Vu
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Correction Loss ◽  
Short Segment ◽  
Hardware Failure ◽  
Transforaminal Interbody Fusion

Abstract Background: Correction loss and hardware failure of short segment posterior pedicle screw fixation in treatment of thoracolumbar unstable burst fracture have been remaining a main concern. Several authors have introduced the procedures to solve these limitations including transforaminal interbody fusion (TIF). The purposes of this study were to evaluate the progressive kyphosis and implant failure of short-segment pedicle screw fixation combined with transforaminal interbody fusion in treatment of unstable thoracolumbar burst fracture.Methods: The retrospective study were enrolled in the patients with isolated unstable thoracolumbar burst fractures, Denis type IIB who were treated by posterior short fixation with TIF between January 2013 to January 2017. Patients were followed up for a minimum of one and half year. For evaluation of correction loss, % loss of anterior vertebral body heights (%AVB), vertebral kyphotic angle (VA) and regional kyphotic angle (RA) were collected preoperatively, postoperatively and at final follow-up. The hardware failure was assessed on radiological images at last follow-up. Results: There were 36 patients who met the inclusion criteria with a mean follow-up duration of 53 months. The mean correction loss of %AVB, VA and, RA were 10.2%, 2.9o and 5.6o, respectively. There were 6 patients (16.7%) with hardware failure at final follow-up. Conclusions: Short-segment posterior pedicle screw fixation with TIF using bone chip graft hasn’t prevented completely the hardware failure and progressive kyphosis in treatment of unstable thoracolumbar burst fracture.

scholarly journals Lateral Lumbar Interbody Fusion and in Situ Screw Fixation for Rostral Adjacent Segment Stenosis of the Lumbar Spine

2017 ◽  
Vol 60 (6) ◽  
pp. 755-762 ◽  
Author(s):  
Young Hoon Choi ◽  
Shin Won Kwon ◽  
Jung Hyeon Moon ◽  
Chi Heon Kim ◽  
Chun Kee Chung ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion

scholarly journals Anatomic Features of the Paramedian Muscle-Splitting Approaches to the Lumbar Spine

2010 ◽  
Vol 66 (suppl_1) ◽  
pp. ons-13-ons-25 ◽  
Author(s):  
Daniel J. Hoh ◽  
Michael Y. Wang ◽  
Stephen L. Ritland
Keyword(s):  
Lumbar Spine ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Surgical Anatomy ◽  
Surgical Access ◽  
Muscle Sparing ◽  
Multiple Levels ◽  
Muscle Groups ◽  
Trauma And Injury

Abstract Background: Intermuscular approaches can expose the lumbar spine and minimize muscular trauma and injury. The segmental anatomy of the posterior lumbar musculature allows surgical access through separation of muscle groups and fascicles and provides one to develop intermuscular working channels while preserving the integrity of the muscles and their function. In addition, preservation of the accompanying neurovascular bundles minimizes blood loss, tissue atrophy, and pain. With these approaches, a variety of procedures for decompression, discectomy, interbody fusion, or pedicle screw fixation can be achieved for single or multiple levels without subperiosteal stripping or muscle transection. Objective: A detailed description of the relevant surgical anatomy for the muscle-sparing approach to the lumbar spine.

Revision surgery of the lumbar spine: anterior lumbar interbody fusion followed by percutaneous pedicle screw fixation

2006 ◽  
Vol 5 (3) ◽  
pp. 228-233 ◽  
Author(s):  
Sang-Ho Lee ◽  
Byung-Uk Kang ◽  
Sang Hyeop Jeon ◽  
Jong Dae Park ◽  
Dae Hyeon Maeng ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Revision Surgery ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Anterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Percutaneous Pedicle Screw ◽  
The Mean ◽  
Percutaneous Pedicle Screw Fixation

Object The aim of this study was to evaluate the efficacy of anterior lumbar interbody fusion (ALIF) augmented by percutaneous pedicle screw fixation (PSF) for revision surgery in the lumbar spine and to determine the prognostic factors affecting surgical outcomes. Methods The population included 54 consecutively treated patients in whom revision surgery involving ALIF with PSF was performed between 2001 and 2004. There were 22 men and 32 women, whose mean age was 59.5 years (range 25–78 years). The diagnoses prior to revision ALIF were as follows: degenerative disc disease in 25 patients, instability/spondylolisthesis in 15, recurrent disc herniation in seven, and pseudarthrosis in seven. The mean follow-up period was 24 months (range 12–52 months). The mean visual analog scale score for back and leg pain decreased, respectively, from 7.8 to 2.3 and 8.0 to 2.3 (p < 0.001). The mean Oswestry Disability Index score improved from 70 to 25% (p < 0.001). Radiological evidence of fusion was noted in 52 of 54 patients. The mean preoperative segmental lordosis, whole lumbar lordosis, and sacral tilt were 15.2, 35.5, and 28.3°, respectively; these values were significantly increased to 20.4, 40.7, and 31.4°, respectively, after revision surgery (p < 0.001). The increase in sacral tilt was positively correlated with improvement in back pain (p = 0.028) and functional status (p = 0.025). Conclusions The results demonstrate that ALIF followed by PSF can be an effective alternative in revision surgery of the lumbosacral spine in selected cases. Not only can solid fusion be achieved, sagittal alignment can also be restored in the majority of patients.

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