Pilates-based exercise in the treatment of a patient with persistent low back pain following transforaminal lumbar interbody fusion

2018 ◽  
Vol 36 (4) ◽  
pp. 542-549
Author(s):  
Lynn Peterson ◽  
Douglas E. Haladay
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion

Surgical treatment of adult degenerative spondylolisthesis by instrumented transforaminal lumbar interbody fusion in the Han nationality

2009 ◽  
Vol 10 (5) ◽  
pp. 496-499 ◽  
Author(s):  
Hao Xu ◽  
Hao Tang ◽  
Zhonghai Li
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Peek Cage ◽  
Han Nationality

Object The transforaminal lumbar interbody fusion (TLIF) procedure was developed to provide the surgeon with a fusion procedure that may reduce many of the risks and limitations associated with posterior lumbar interbody fusion, yet produce similar stability in the spine. There are few large series with long-term follow-up data regarding instrumented TLIF and placement of 1 diagonal polyetheretherketone (PEEK) cage. The authors performed a prospective study to evaluate the outcome and safety of instrumented TLIF with 1 diagonal PEEK cage for degenerative spondylolisthesis in the Han nationality in China. Methods Between May 2001 and April 2006, 60 patients (35 men and 25 women; mean age 55.5 years, range 45–70 years) with symptomatic degenerative spondylolisthesis underwent the TLIF procedure with 1 diagonal PEEK cage and additional pedicle screw internal fixation at the authors' institution. The inclusion criteria involved degenerative spondylolisthesis (Grades I and II) in patients with chronic low-back pain with or without leg pain. Results One patient had a postoperative temporary motor and sensory deficit of the adjacent nerve root. Reoperation was required in 1 patient because of pedicle screw migration. One patient developed a pseudarthrosis and had increasing complaints of low-back pain 1 year postoperatively and underwent a subsequent revision surgery. Two patients had nerve root symptomatic compression resulting from cage migration and insufficient decompression after surgery, and they underwent revision. Two patients had a dural tear that required fibrin glue application during surgery. No implant fracture or subsidence occurred in any patient. Clinically, the pain index and Oswestry Disability Index (ODI) score improved significantly from before surgery to the 2-year follow-up. In the TLIF group, the pain index improved from 69 to 25 (p < 0.001). The postoperative ODI showed a significant postoperative reduction of disability during the whole period of follow-up (p < 0.001). The preoperative mean ODI score was 32.3 (16–80), and postoperative 13.1 (0–28). Disc space height and foraminal height were restored by the surgery and maintained at the latest follow-up time. Conclusions In the authors' experience, instrumented TLIF with 1 diagonal PEEK cage can be a surgical option for treatment of degenerative spondylolisthesis in the Han nationality in China.

Dorsal Lumbar Interbody Fusion for Chronic Axial, Mechanical Low Back Pain: A Modification of Two Established Techniques

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONS102-ONS107 ◽  
Author(s):  
Robert F. Heary ◽  
Sanjeev Kumar ◽  
Reza J. Karimi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Modified Technique ◽  
Nerve Roots ◽  
Advantages And Disadvantages

Abstract LUMBAR SPINAL FUSION is a popular method for treating degenerative disc disease leading to chronic low back pain. Some of the techniques most commonly undertaken are posterior lumbar interbody fusion and transforaminal lumbar interbody fusion. These techniques have their own advantages and disadvantages. In this article, we briefly describe a modified technique, dorsal lumbar interbody fusion, which retains the advantages and avoids the disadvantages of the others. The goal of this procedure is to combine the aggressive decompression of both the thecal sac and bilateral nerve roots and symmetrical bilateral graft placement obtained via the posterior lumbar interbody fusion with the transforaminal placement of interbody grafts obtained via the transforaminal lumbar interbody fusion procedure. This modification has several advantages: it permits more aggressive removal of the disc bilaterally, larger and more symmetrical lordotic-shaped carbon fiber cages and structural allograft can be placed bilaterally, and the nerve roots can be aggressively decompressed bilaterally.

scholarly journals Comparative Study between Transforaminal Lumbar Interbody Fusion and Posterolateral Fusion for Treatment of Spondylolisthesis: Clinical Outcomes and Spino-Pelvic Sagittal Balance Parameters

2021 ◽  
Vol 18 (01) ◽  
pp. 51-58
Author(s):  
Majid Reza Farrokhi ◽  
Keyvan Eghbal ◽  
Seyed Reza Mousavi ◽  
Mustafa Moumani ◽  
Khshayar Bazyari ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sagittal Balance ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Radicular Pain ◽  
Low Grade ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Significant Difference

Abstract Objective This retrospective study aims to compare the clinical and radiological outcomes of posterolateral fusion (PLF) with transforaminal lumbar interbody fusion (TLIF + PLF) for the treatment of patients with low-grade spondylolisthesis. Methodology A total of 77 adult patients ≥18 years with low-grade spondylolisthesis, Meyerding grades I and II, were assigned into two groups: 36 patients treated with PLF and 41 patients treated with TLIF + PLF. The PLF group is composed of the patients that were operated with pedicle screw and the TLIF + PLF group is composed of the ones that were operated with fixation and TILF by autografting. Clinical evaluation was performed using the spino-pelvic sagittal balance, Numeric Rating Scale, Oswestry Disability Index, blood loss, operation times, and postoperative hospital stay of the PLF vs TLIF groups. The incidences of postoperative low back pain and radicular pain in the two groups were also recorded. Radiography was performed preoperatively and postoperatively to assess spino-pelvic parameters. Results Significant restoration of spino-pelvic sagittal balance was observed in the TLIF group after surgery, and all spino-pelvic sagittal balance parameters showed significant improvement in the TLIF group after surgery, while in the PLF group, all spino-pelvic sagittal parameters had improved except the segmental angle lordosis (p = 0.316), which showed no significant difference after surgery in the PLF group. Postoperative pelvic incidence and pelvic tilt significantly improved in the TLIF group in comparison to PLF groups. Hence, TLIF can achieve better postoperative spino-pelvic sagittal balance parameters than PLF. There was no difference in the complication rates for each group. Both groups achieved significant improvement in postoperative clinical outcomes, and there was no significant difference in the incidence of postoperative low back pain or radicular pain between the two groups. Conclusion Both surgical procedures PLF and TLIF were effective. PLF and TLIF can result in improved clinical and radiological outcomes for patients treated for low-grade spondylolisthesis. TLIF can achieve better restoration of spino-pelvic sagittal balance parameters than PLF alone.

Transforaminal Lumbar Interbody Fusion: Technique, Complications, and Early Results

Neurosurgery ◽  
2001 ◽  
Vol 48 (3) ◽  
pp. 569-575 ◽  
Author(s):  
William S. Rosenberg ◽  
Praveen V. Mummaneni
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pedicle Screw ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Pedicle Screws ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Brachial Plexopathy ◽  
Low Back ◽  
Lumbar Interbody Fusion

Abstract OBJECTIVE To demonstrate the safety, surgical efficacy, and advantages of the transforaminal approach for lumbar interbody fusion when combined with pedicle screw fixation. METHODS We retrospectively reviewed the records of 22 patients (age range, 34–63 yr; mean, 49 yr) with Grade I or II spondylolisthesis who underwent transforaminal lumbar interbody fusion. Nineteen patients presented with low back pain and associated radiculopathy, and three presented with low back pain only. Transforaminal lumbar interbody fusion was performed at L4-L5 in 8 patients, L5-S1 in 11 patients, L3-L4 and L4-L5 in 2 patients, and L4-L5 and L5-S1 in 1 patient. Periodic follow-up took place 1 to 12 months after surgery (mean, 5.3 mo). Decompression is performed according to clinical circumstances. Pedicle screws are placed, and a discectomy is carried out. The cartilaginous endplates are removed. The interspace is gradually distracted, resulting in lost disc height being regained, and interbody fusion cages are positioned. The pedicle screw-and-rod construct is then compressed, restoring lumbar lordosis. RESULTS Low back pain completely resolved in 16 patients, moderate relief from pain was achieved in 5 patients, and the pain was unchanged in one patient. Nonneurological complications included intraoperative durotomy in one patient and postoperative wound infection in two. In one patient, postoperative mild L5 motor paresis resolved. One patient had a temporary brachial plexopathy due to intraoperative positioning, and one patient had peripheral polyneuropathy secondary to prolonged intraoperative blood pressure cuff inflation. CONCLUSION Transforaminal lumbar interbody fusion is a safe and effective method for achieving circumferential spinal fusion via a single-stage procedure. This procedure is particularly useful in restoring disc space height and lumbar lordosis.

Intramuscular pressure of the multifidus muscle and low-back pain after posterior lumbar interbody fusion: comparison of mini-open and conventional approaches

2013 ◽  
Vol 19 (6) ◽  
pp. 651-657 ◽  
Author(s):  
Yoshihiro Mukai ◽  
Shota Takenaka ◽  
Noboru Hosono ◽  
Toshitada Miwa ◽  
Takeshi Fuji
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Intramuscular Pressure ◽  
Multifidus Muscle ◽  
Screw Insertion ◽  
Mini Open

Object This randomized study was designed to elucidate the time course of the perioperative development of intramuscular multifidus muscle pressure after posterior lumbar interbody fusion (PLIF) and to investigate whether the route of pedicle screw insertion affects this pressure and resultant low-back pain. Although several studies have focused on intramuscular pressure associated with posterior lumbar surgery, those studies examined intramuscular pressure generated by the muscle retractors during surgery. No study has investigated the intramuscular pressure after PLIF. Methods Forty patients with L4–5 degenerative spondylolisthesis were randomly assigned to undergo either the mini-open PLIF procedure with pedicle screw insertion between the multifidus and longissimus muscles (n = 20) or the conventional PLIF procedure via a midline approach only (n = 20). Intramuscular pressure was measured 5 times (at 30 minutes and at 6, 12, 24, and 48 hours after surgery) with an intraoperatively installed sensor. Concurrently, the FACES Pain Rating Scale score for low-back pain and the total dose of postoperative analgesics were recorded. Results With the patients in the supine position, for both groups the mean pressure values were consistently 40–50 mm Hg, which exceeded the critical capillary pressure of the muscle. With the patients in the lateral decubitus position, the pressure decreased over time (from 14 to 9 mm Hg in the mini-open group and from 20 to 10 mm Hg in the conventional group). Among patients in the mini-open group, the pressure was lower, but the difference was not statistically significant. Postoperative pain and postoperative analgesic dosages were also lower . Conclusions To the authors' knowledge, this is the first study to evaluate postoperative intramuscular pressure after PLIF. Although the results did not demonstrate a significant difference in the intramuscular pressure between the 2 types of PLIF, mini-open PLIF was associated with less pain after surgery. Clinical trial registration no.: UMIN000010069 (www.umin.ac.jp/ctr/index.htm).

Vertebral osteolytic defect due to cellulose particles derived from gauze fibers after posterior lumbar interbody fusion

2014 ◽  
Vol 21 (6) ◽  
pp. 877-881 ◽  
Author(s):  
Shota Takenaka ◽  
Yoshihiro Mukai ◽  
Noboru Hosono ◽  
Kosuke Tateishi ◽  
Takeshi Fuji
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Histopathological Examination ◽  
Lumbar Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Body Type ◽  
Initial Surgery

Vertebral cystic lesions may be observed in pseudarthroses after lumbar fusion surgery. The authors report a rare case of pseudarthrosis after spinal fusion, accompanied by an expanding vertebral osteolytic defect induced by cellulose particles. A male patient originally presented at the age of 69 years with leg and low-back pain caused by a lumbar isthmic spondylolisthesis. He underwent a posterior lumbar interbody fusion, and his neurological symptoms and pain resolved within a year but recurred 14 months after surgery. Radiological imaging demonstrated a cystic lesion on the inferior endplate of L-5 and the superior endplate of S-1, which rapidly enlarged into a vertebral osteolytic defect. The patient underwent revision surgery, and his low-back pain resolved. A histopathological examination demonstrated foreign body–type multinucleated giant cells, containing 10-μm particles, in the sample collected just below the defect. Micro–Fourier transform infrared spectroscopy revealed that the foreign particles were cellulosic, presumably originating from cotton gauze fibers that had contaminated the interbody cages used during the initial surgery. Vertebral osteolytic defects that occur after interbody fusion are generally presumed to be the result of infection. This case suggests that some instances of vertebral osteolytic defects may be aseptically induced by foreign particles. Hence, this possibility should be carefully considered in such cases, to help prevent contamination of the morselized bone used for autologous grafts by foreign materials, such as gauze fibers.

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