Modified Facet Joint Fusion for Lumbar Degenerative Disease: Case Series of a Fusion Technique, Clinical Outcomes, and Fusion Rate in 491 Patients

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S144-S144
Author(s):  
Zhinan Ren ◽  
Zheng Li ◽  
Shugang Li ◽  
Derong Xu ◽  
Xin Chen
Keyword(s):  
Clinical Outcomes ◽  
Facet Joint ◽  
Case Series ◽  
Fusion Rate ◽  
Degenerative Disease ◽  
Lumbar Degenerative Disease ◽  
Fusion Technique ◽  
Joint Fusion ◽  
Disease Case ◽  
Facet Joint Fusion

Modified Facet Joint Fusion for Lumbar Degenerative Disease: Case Series of a Fusion Technique, Clinical Outcomes, and Fusion Rate in 491 Patients

2020 ◽  
Vol 19 (3) ◽  
pp. 255-263
Author(s):  
Zhinan Ren ◽  
Zheng Li ◽  
Shugang Li ◽  
Derong Xu ◽  
Xin Chen
Keyword(s):  
Clinical Outcomes ◽  
Facet Joint ◽  
Fusion Rate ◽  
Promising Alternative ◽  
Fusion Technique ◽  
Joint Fusion ◽  
Disease Case ◽  
Facet Joint Fusion ◽  
Lumbar Spondylolisthesis

Abstract BACKGROUND Controversy still exists regarding the optimal fusion technique for the treatment of unstable lumbar spondylolisthesis. OBJECTIVE To evaluate the safety and efficacy of modified facet joint fusion (MFF). METHODS A total of 491 patients with unstable lumbar spondylolisthesis who underwent MFF were retrospectively reviewed. Computed tomography was used to evaluate the fusion rate of MFF at 6- and 12-mo follow-up postoperatively. Clinical outcomes included visual analog scale pain scores for low back pain (VAS-LBP) and leg pain (VAS-LP), Japanese Orthopedic Association scores (JOA), and Oswestry Disability Index (ODI), all of which were obtained preoperatively and postoperatively at 1-, 3-, 6-, and 12-mo follow-up times. The clinical outcomes were determined to be excellent, good, fair, or poor according to the MacNab classification at the last follow-up time. RESULTS Of the 491 patients, the fusion rates at the 6-mo and 1-yr follow-up were 56.8% and 96.1%, respectively. Between baseline and 1-yr follow-up time, VAS-LP and VAS-LBP improved from 5.6 ± 0.9 to 0.4 ± 0.5 and 5.1 ± 1.2 to 1.5 ± 0.9, respectively (P < .001). JOA improved from 9.0 ± 2.0 to 27.7 ± 1.0, and ODI decreased from 64.0 ± 2.0 to 19 ± 1.0 (P < .001). At the final evaluation, 93.6% patients showed excellent or good results, and 3.2% showed fair results. There were no MFF technique-related complications. CONCLUSION MFF technique achieved satisfactory clinical outcomes and fusion rate and appears to be a promising alternative fusion technique for the treatment of unstable lumbar spondylolisthesis.

Discectomy combined with isolated facet joint fusion—as an alternative fusion technique. Our clinical experience

2008 ◽  
Vol 19 (1) ◽  
pp. 1-6
Author(s):  
Sudeep Jain ◽  
Devdatta Suhas Neogi ◽  
Baldeep Singh ◽  
Saurabh Singh ◽  
Ramesh Kumar ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Facet Joint ◽  
Fusion Technique ◽  
Joint Fusion ◽  
Facet Joint Fusion

scholarly journals Prophylactic muscle flap reconstruction after complex spine surgery for degenerative disease: case series and institutional protocol

2018 ◽  
Vol 4 (3) ◽  
pp. 560-567 ◽  
Author(s):  
Nikhil Adapa ◽  
Nikhil Jain ◽  
Allison Capek ◽  
Rajiv Chandawarkar ◽  
Safdar N. Khan ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Case Series ◽  
Muscle Flap ◽  
Degenerative Disease ◽  
Flap Reconstruction ◽  
Disease Case

scholarly journals Comparison of clinical outcomes achieved with oblique lateral interbody fusion with or without supplementary instrumentation in patients with single-level lumbar degenerative disease

2021 ◽  
Author(s):  
Zhao Lang ◽  
Yuqing Sun ◽  
Qiang Yuan ◽  
Jingye Wu ◽  
Mingxing Fan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Disease ◽  
Mineral Density ◽  
Lumbar Degenerative Disease ◽  
Single Level ◽  
Lateral Interbody Fusion ◽  
Estimated Blood Loss ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Abstract Background Oblique lateral interbody fusion (OLIF) is applied often to treat degenerative disc disease in the lumbar spine. Stand-alone OLIF prevents morbidities associated with supplemental fixation and is less expensive. However, it remains controversial whether stand-alone OLIF is sufficient to avoid subsidence for single-level diseases. Additionally, bilateral pedicle screw (BPS) and bilateral transfacet screw (BTS) fixation are well-established posterior fixation methods that can offer improved biomechanical stability. But the comparison of clinical outcomes of OLIF with and without supplementary instrumentation is lack. Methods We retrospectively examined 20 patients who underwent single-level stand-alone OLIF for symptomatic lumbar degenerative disease at L1–L5 (SA group). Groups of patients treated with OLIF plus BPS (n = 20, BPS group) or BTS (n = 20, BTS group) were matched for age, sex, diagnosis, operative level, body mass index, and bone mineral density. The disk height index (DHI), segmental lordotic (SL) angle, and lumbar lordotic (LL) angle were measured preoperatively and at 3 days and 6 months postoperatively. Clinical outcomes were evaluated. Results Significant disc height loss was observed in all groups, but was greater in the SA and BTS groups than in the BPS group at the 6-month follow-up. The SL and LL angles were not affected in any group. The operative time was significantly less in the SA group, and the estimated blood loss was significantly higher in the BPS group. At 6 months post-surgery, improvements in clinical outcomes were evident in all groups, but the VAS (back pain), JOA, and ODI scores were worse in the SA group than in the other groups. Conclusions Stand-alone OLIF was associated with greater subsidence and poorer clinical outcomes compared with OLIF plus supplementary instrumentation. The addition of BTS did not decrease the degree of subsidence, but provided clinical outcomes comparable to those achieved with BPS.

Fusion technique does not affect short-term patient-reported outcomes for lumbar degenerative disease

2019 ◽  
Vol 19 (12) ◽  
pp. 1960-1968 ◽  
Author(s):  
Srikanth N. Divi ◽  
Gregory D. Schroeder ◽  
Dhruv K.C. Goyal ◽  
Kristen E. Radcliff ◽  
Matthew S. Galetta ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Degenerative Disease ◽  
Short Term ◽  
Lumbar Degenerative Disease ◽  
Fusion Technique ◽  
Patient Reported

Secondary Subtalar Joint Osteoarthritis Following Total Ankle Replacement

2019 ◽  
Vol 40 (10) ◽  
pp. 1122-1128 ◽  
Author(s):  
Marc Sokolowski ◽  
Nicola Krähenbühl ◽  
Chen Wang ◽  
Lukas Zwicky ◽  
Christine Schweizer ◽  
...  
Keyword(s):  
Subtalar Joint ◽  
Case Series ◽  
Fusion Rate ◽  
Total Ankle Replacement ◽  
Time Interval ◽  
Level Of Evidence ◽  
Joint Fusion ◽  
Ankle Replacement ◽  
Cystic Changes

Background:An advantage of total ankle replacement (TAR) compared to ankle fusion is that by maintaining motion, the occurrence of hypermobility of adjacent joints may be prevented. This could affect the development of symptomatic subtalar joint osteoarthritis (OA). The aim of the study was to determine the incidence of subtalar joint fusion and the progression of subtalar joint OA following TAR.Methods:Secondary subtalar joint fusion rate was determined from a cohort of 941 patients receiving primary TAR between 2000 and 2016. The indication for fusion, the time interval from primary TAR to fusion, and the union rate were evaluated. To assess the progression of subtalar joint OA, degenerative changes of the subtalar joint were classified in 671 patients using the Kellgren-Lawrence score (KLS) prior to TAR and at latest follow-up.Results:In 4% (37) of the patients, a secondary subtalar joint fusion was necessary. The indication for fusion was symptomatic OA in 51% (19), hindfoot instability in 27% (10), osteonecrosis of the talus in 19% (7), and cystic changes of the talus in 3% (1) of the patients. Time from primary TAR to subtalar joint fusion due to progressive OA was 5.0 (range, 0.3-10) years and for other reasons 1.6 (range, 0.2-11.6) years ( P = .3). In 68% (456) of the patients, no progression of subtalar joint OA was observed.Conclusion:The incidence of secondary subtalar joint fusion was low. The most common reason for subtalar joint fusion following TAR was symptomatic OA.Level of Evidence:Level IV, case series.

scholarly journals Comparison of clinical outcomes achieved with oblique lateral interbody fusion with or without supplementary instrumentation in patients with single-level lumbar degenerative disease

2021 ◽  
Author(s):  
Zhao Lang ◽  
Yuqing Sun ◽  
Qiang Yuan ◽  
Jingye Wu ◽  
Mingxing Fan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Disease ◽  
Mineral Density ◽  
Lumbar Degenerative Disease ◽  
Single Level ◽  
Lateral Interbody Fusion ◽  
Estimated Blood Loss ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Abstract Background Oblique lateral interbody fusion (OLIF) is applied often to treat degenerative disc disease in the lumbar spine. Stand-alone OLIF prevents morbidities associated with supplemental fixation and is less expensive. However, it remains controversial whether stand-alone OLIF is sufficient to avoid subsidence for single-level diseases. Additionally, bilateral pedicle screw (BPS) and bilateral transfacet screw (BTS) fixation are well-established posterior fixation methods that can offer improved biomechanical stability. But the comparison of clinical outcomes of OLIF with and without supplementary instrumentation is lack. Methods We retrospectively examined 20 patients who underwent single-level stand-alone OLIF for symptomatic lumbar degenerative disease at L1–L5 (SA group). Groups of patients treated with OLIF plus BPS (n = 20, BPS group) or BTS (n = 20, BTS group) were matched for age, sex, diagnosis, operative level, body mass index, and bone mineral density. The disk height index (DHI), segmental lordotic (SL) angle, and lumbar lordotic (LL) angle were measured preoperatively and at 3 days and 6 months postoperatively. Clinical outcomes were evaluated. Results Significant disc height loss was observed in all groups, but was greater in the SA and BTS groups than in the BPS group at the 6-month follow-up. The SL and LL angles were not affected in any group. The operative time was significantly less in the SA group, and the estimated blood loss was significantly higher in the BPS group. At 6 months post-surgery, improvements in clinical outcomes were evident in all groups, but the VAS (back pain), JOA, and ODI scores were worse in the SA group than in the other groups. Conclusions Stand-alone OLIF was associated with greater subsidence and poorer clinical outcomes compared with OLIF plus supplementary instrumentation. The addition of BTS did not decrease the degree of subsidence, but provided clinical outcomes comparable to those achieved with BPS.

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