Management of Infected Transforaminal Lumbar Interbody Fusion Cage in Posterior Degenerative Lumbar Spine Surgery

2019 ◽  
Vol 126 ◽  
pp. e330-e341 ◽  
Author(s):  
Chia-Wei Chang ◽  
Tsai-Sheng Fu ◽  
Wen-Jer Chen ◽  
Chien-Wen Chen ◽  
Po-Liang Lai ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Spine Surgery ◽  
Lumbar Interbody Fusion ◽  
Degenerative Lumbar Spine ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Biomechanical comparison of transdiscal fixation and posterior fixation with and without transforaminal lumbar interbody fusion in the treatment of L5–S1 lumbosacral joint

2018 ◽  
Vol 232 (4) ◽  
pp. 371-377 ◽  
Author(s):  
Hakan Özalp ◽  
Mustafa Özkaya ◽  
Onur Yaman ◽  
Teyfik Demir
Keyword(s):  
Pedicle Screw ◽  
Axial Compression ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Posterior Fixation ◽  
Lumbar Interbody Fusion ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Transdiscal screw fixation is generally performed in the treatment of high-grade L5–S1 spondylolisthesis. The main thought of the study is that the biomechanical performances of the transdiscal pedicle screw fixation can be identical to standard posterior pedicle screw fixations with or without transforaminal lumbar interbody fusion cage insertion. Lumbosacral portions and pelvises of 45 healthy lambs’ vertebrae were dissected. Animal cadavers were randomly and equally divided into three groups for instrumentation. Three fixation systems, L5–S1 posterior pedicle screw fixation, L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion, and L5–S1 transdiscal pedicle screw fixation, were generated. Axial compression, flexion, and torsion tests were conducted on test samples of each system. In axial compression, L5–S1 transdiscal fixation was less stiff than L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion. There were no significant differences between groups in flexion. Furthermore, L5–S1 posterior fixation was stiffest under torsional loads. When axial compression and flexion loads are taken into consideration, transdiscal fixation can be alternatively used instead of posterior pedicle screw fixation in the treatment of L5–S1 spondylolisthesis because it satisfies enough stability. However, in torsion, posterior fixation is shown as a better option due to its higher stiffness.

scholarly journals Delayed Ejaculation After Lumbar Spine Surgery: A Claims Database Analysis

2020 ◽  
pp. 219256822096243
Author(s):  
Hriday P. Bhambhvani ◽  
Alex M. Kasman ◽  
Chiyuan A. Zhang ◽  
Serena S. Hu ◽  
Michael L. Eisenberg
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Multivariable Analysis ◽  
Thoracolumbar Spine ◽  
Lumbar Spine Surgery ◽  
Lumbar Interbody Fusion ◽  
Delayed Ejaculation ◽  
Institutional Experience

Study Design: Retrospective cohort. Objectives: Delayed ejaculation (DE) is a distressing condition characterized by a notable delay in ejaculation or complete inability to achieve ejaculation, and there are no existing reports of DE following lumbar spine surgery. Inspired by our institutional experience, we sought to assess national rates of DE following surgery of the lumbar spine. Methods: We queried the Optum De-identified Clinformatics Database for adult men undergoing surgery of the lumbar spine between 2003 and 2017. The primary outcome was the development of DE within 2 years of surgery. Multivariable logistic regression was performed to identify factors associated with the development of DE. Results: We identified 117 918 men who underwent 162 646 lumbar spine surgeries, including anterior lumbar interbody fusion (ALIF), posterior lumbar fusion (PLF), and more. The overall incidence of DE was 0.09%, with the highest rate among ALIF surgeries at 0.13%. In multivariable analysis, the odds of developing DE did not vary between anterior/lateral lumbar interbody fusion, PLF, and other spine surgeries. A history of tobacco smoking (OR = 1.47, 95% CI 1.00-2.16, P = .05) and obesity (OR = 1.56, 95% CI 1.00-2.44, P = .05) were associated with development of DE. Conclusions: DE is a rare but distressing complication of thoracolumbar spine surgery, and patients should be queried for relevant symptoms at postoperative visits when indicated.

scholarly journals Comparative analysis of transforaminal lumbar interbody fusion versus posterolateral instrumented fusion in degenerative lumbar spine disorders

2020 ◽  
Vol 27 (2) ◽  
pp. 173-178
Author(s):  
Sanjay Yadav ◽  
Saurabh Singh ◽  
Raj Kumar Arya ◽  
Alok Kumar ◽  
Ishan Kumar ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Blood Loss ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Inclusion Criteria ◽  
Degenerative Lumbar Spine ◽  
Significant Difference ◽  
Spine Disorders

Objectives: Spinal fusion is an effective treatment for degenerative lumbar spine; however, conflicting results exist regarding the best procedure. This study compares the clinical and radiological outcomes of transforaminal lumbar interbody fusion (TLIF) versus instrumented posterolateral fusion (PLF) in patients of degenerative lumbar spine disorders. Methods: Of the total 37 patients, 16 patients were operated with TLIF and 21 were operated with instrumented PLF with bone grafting. Duration of the study was from June 2017 to June 2019. Patients fulfilling the inclusion criteria were included in the study. Inclusion criteria were (1) age of patient ranging from 18 years to 70 years, (2) involvement of single level, (3) diagnosis of degenerative spine disease, and (4) minimum follow-up of 1 year. Radiographic parameters such as slippage of vertebrae, anterior and posterior disc heights, local disc lordosis, T12–S1 angle were measured, and fusion were assessed; comparison between preoperative and postoperative parameters was also done. Clinical outcome score was obtained using visual analog scale (VAS) and Oswestry disability index (ODI). Statistical analysis was done using SPSS software. Results: No significant difference was found in ODI and VAS between TLIF and PLF. Restoration of disc height and improvement of local disc lordosis was better in the TLIF group than in the PLF group. The fusion rate was 87.5% in the TLIF group and 81% in the instrumented PLF group. Amount of blood loss was slightly higher in the TLIF group (319.69 ± 53.8 mL) than in the instrumented PLF group (261.19 ± 34.9 mL). Operating time was also slightly higher in TLIF (133 ± 6.02 min) than in instrumented PLF (90.71 ± 6.3 min). Conclusion: TLIF is superior to instrumented PLF in terms of restoration of anterior and posterior disc heights and improvement in local disc lordosis and higher fusion rate, however it requires greater surgical expertise and more experience. Because of anterior cage support, early weight-bearing mobilization can be allowed in the TLIF group compared to the PLF group. Surgical time and blood loss were slightly higher in cases of TLIF than instrumented PLF.

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