Effect of Single-Level Transforaminal Lumbar Interbody Fusion on Segmental and Overall Lumbar Lordosis in Patients with Lumbar Degenerative Disease

2018 ◽  
Vol 109 ◽  
pp. e244-e251 ◽  
Author(s):  
Xiaofei Cheng ◽  
Feng Zhang ◽  
Kai Zhang ◽  
Xiaojiang Sun ◽  
Changqing Zhao ◽  
...  
1999 ◽  
Vol 7 (6) ◽  
pp. E10 ◽  
Author(s):  
Mark R. McLaughlin ◽  
Jonathan Y. Zhang ◽  
Brian R. Subach ◽  
Regis W. Haid ◽  
Gerald E. Rodts

In recent years, there has been an unprecedented increase in the number of patients undergoing treatment with interbody fusion devices for degenerative disease of the lumbar spine. These devices can be placed either anteriorly or posteriorly. With the advent of minimally invasive surgery and the increasing ability of general surgeons to perform transperitoneal procedures laparoscopically, a new laparoscopic technique has been developed for placing lumbar interbody fusion devices. Although this procedure has some advantages over posterior lumbar interbody fusion, it is not without significant risk, and the learning curve is steep. The authors review a series of 32 consecutive patients who underwent single-level laparoscopic anterior lumbar interbody fusion at L4–5 or L5–S1 over a 2-year period for the treatment of single-level lumbar degenerative disease. In this report they review the technical aspects of the procedure and the important lessons they have learned through their early experience with this technique.


Neurosurgery ◽  
2017 ◽  
Vol 81 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Timothy J. Yee ◽  
Jacob R. Joseph ◽  
Samuel W. Terman ◽  
Paul Park

Abstract BACKGROUND: One criticism of transforaminal lumbar interbody fusion (TLIF) is the inability to increase segmental lordosis (SL). Expandable interbody cages are a relatively new innovation theorized to allow improvement in SL. OBJECTIVE: To compare changes in SL and lumbar lordosis (LL) after TLIF with nonexpandable vs expandable cages. METHODS: We performed a retrospective cohort study of patients who were ≥18 years old and underwent single-level TLIF between 2011 and 2014. Patients were categorized by cage type (static vs expandable). Primary outcome of interest was change in SL and LL from preoperative values to those at 1 month and 1 year postoperatively. RESULTS: A total of 89 patients were studied (48 nonexpandable group, 41 expandable group). Groups had similar baseline characteristics. For SL, median (interquartile range) improvement was 3° for nonexpandable and 2° for expandable (unadjusted, P = .09; adjusted, P = .68) at 1 month postoperatively, and 3° for nonexpandable and 1° for expandable (unadjusted, P = .41; adjusted, P = .28) at 1 year postoperatively. For LL, median improvement was 1° for nonexpandable and 2° for expandable (unadjusted, P = .20; adjusted, P = .21), and 2° for nonexpandable and 5° for expandable (unadjusted, P = .15; adjusted, P = .51) at 1 year postoperatively. After excluding parallel expandable cages, there was still no difference in SL or LL improvement at 1 month or 1 year postoperatively between static and expandable cages (both unadjusted and adjusted, P > .05). CONCLUSION: Patients undergoing single-level TLIF experienced similar improvements in SL and LL regardless of whether nonexpandable or expandable cages were placed.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
You-Di Xue ◽  
Wen-Bo Diao ◽  
Chao Ma ◽  
Jie Li

Abstract Purpose This study aimed to evaluate the clinical efficacy and imaging results of percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) through comparing it with minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF). Materials and methods We performed a retrospective analysis on patients with lumbar degenerative disease treated by PETLIF or MISTLIF from September 2017 to January 2019, and the patients were divided into two groups: the PETLIF group and the MISTLIF group. The clinical and imaging parameters of the two groups were evaluated. Results There was no significant difference between the two groups in operative time and complication rate. The estimated blood loss and the length of hospital stay in the PETLIF group were significantly better than those in the MISTLIF group. Compared with those before operation, the postoperative VAS-L and VAS-B scores were significantly improved after operation in the both groups. In addition, the postoperative VAS-B score of the PETLIF group was significantly lower than that of the MISTLIF group. At the last follow-up, there was no significant difference between the two groups in the VAS-L score, VAS-B score, ODI score, and bony fusion rate. Conclusions Both PETLIF and MISTLIF could achieve satisfactory clinical outcomes in the treatment of lumbar degenerative disease, but our study suggested that PETLIF had less damage, rapid recovery after operation, and short discharge time.


Neurosurgery ◽  
2017 ◽  
Vol 80 (6) ◽  
pp. 880-886 ◽  
Author(s):  
Zachary J. Tempel ◽  
Gurpreet S. Gandhoke ◽  
Bryan D. Bolinger ◽  
Nicolas K. Khattar ◽  
Philip V. Parry ◽  
...  

Abstract BACKGROUND: Annual incidence of symptomatic adjacent level disease (ALD) following lumbar fusion surgery ranges from 0.6% to 3.9% per year. Sagittal malalignment may contribute to the development of ALD. OBJECTIVE: To describe the relationship between pelvic incidence-lumbar lordosis (PI-LL) mismatch and the development of symptomatic ALD requiring revision surgery following single-level transforaminal lumbar interbody fusion for degenerative lumbar spondylosis and/or low-grade spondylolisthesis. METHODS: All patients who underwent a single-level transforaminal lumbar interbody fusion at either L4/5 or L5/S1 between July 2006 and December 2012 were analyzed for pre- and postoperative spinopelvic parameters. Using univariate and logistic regression analysis, we compared the spinopelvic parameters of those patients who required revision surgery against those patients who did not develop symptomatic ALD. We calculated the predictive value of PI-LL mismatch. RESULTS: One hundred fifty-nine patients met the inclusion criteria. The results noted that, for a 1° increase in PI-LL mismatch (preop and postop), the odds of developing ALD requiring surgery increased by 1.3 and 1.4 fold, respectively, which were statistically significant increases. Based on our analysis, a PI-LL mismatch of >11° had a positive predictive value of 75% for the development of symptomatic ALD requiring revision surgery. CONCLUSIONS: A high PI-LL mismatch is strongly associated with the development of symptomatic ALD requiring revision lumbar spine surgery. The development of ALD may represent a global disease process as opposed to a focal condition. Spine surgeons may wish to consider assessment of spinopelvic parameters in the evaluation of degenerative lumbar spine pathology.


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