Good Clinical Outcomes and Fusion Rate of Facet Fusion With a Percutaneous Pedicle Screw System for Degenerative Lumbar Spondylolisthesis

Spine ◽  
2015 ◽  
Vol 40 (9) ◽  
pp. E552-E557 ◽  
Author(s):  
Tomohiro Miyashita ◽  
Hiromi Ataka ◽  
Kei Kato ◽  
Takaaki Tanno
Keyword(s):  
Pedicle Screw ◽  
Clinical Outcomes ◽  
Fusion Rate ◽  
Percutaneous Pedicle Screw ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis

scholarly journals Reduction and monosegmental fusion for lumbar spondylolisthesis with a long tab percutaneous pedicle screw system: “swing” technique

2019 ◽  
Vol 46 (5) ◽  
pp. E11
Author(s):  
Bumsoo Park ◽  
Sung-Hyun Noh ◽  
Jeong-Yoon Park
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Clinical Outcomes ◽  
Demographic Data ◽  
Reduction Rate ◽  
Pedicle Screws ◽  
Radiological Parameters ◽  
Percutaneous Pedicle Screw ◽  
Segmental Lordosis ◽  
Lumbar Spondylolisthesis

OBJECTIVEWith the development of minimally invasive procedures, percutaneous pedicle screw systems have been used to attempt to correct spondylolisthesis. No previous studies have reported on reduction measures using long tab percutaneous pedicle screws for spondylolisthesis. Additional intraoperative correction has been proposed with the “swing” technique. This study was conducted to compare the efficacy of standard minimally invasive transforaminal interbody fusion (MIS-TLIF) with the efficacy of MIS-TLIF with the “swing” technique (MIS-TLIF and swing) in lumbar spondylolisthesis.METHODSThis was a matched-control study and included 30 consecutive patients who were followed up for 6 months after surgery. Of those patients, 15 were treated with operative reduction via MIS-TLIF with the “swing” technique, whereas the other 15 were treated with the standard MIS-TLIF procedure. The swing technique is a new reduction procedure for use with long tab percutaneous screws. In the swing technique, the entire system is swung back and forth several times after all constructs are placed. Only patients with Meyerding grade I or II lumbar spondylolisthesis were included in the study (18 with grade I and 12 with grade II). Perioperative and clinical outcomes, radiological parameters (Meyerding grade, percentage of slip, slip correction rate, segmental lordosis, and lumbar lordosis) were compared between groups at 6 months after surgery.RESULTSDemographic data did not differ significantly between the 2 groups. Postoperative clinical outcomes showed significant improvement in both groups. Postoperative radiological parameters showed that the degree of spondylolisthesis (swing: 4.7% vs standard: 8.9%) and reduction rate (swing: 77.3% vs standard: 57.1%) favored the swing group. The swing technique effectively decreased the degree of spondylolisthesis (swing: 24.1% to 4.7% vs standard: 21.8% to 8.9%). No complications related to the procedure were reported.CONCLUSIONSMIS-TLIF with the “swing” technique with long tab percutaneous pedicle screws is a safe and effective reduction method for monosegmental spondylolisthesis. This technique cannot only alleviate symptoms but also achieve nearly completely reduction of slippage.

scholarly journals Degenerative Lumbar Spondylolisthesis with Spinal Stenosis: A Comparative Study of 5-Year Outcomes Following Decompression with Fusion and Microendoscopic Decompression

2018 ◽  
Vol 12 (1) ◽  
pp. 132-139 ◽  
Author(s):  
Takato Aihara ◽  
Tomoaki Toyone ◽  
Yasuaki Murata ◽  
Kazuhide Inage ◽  
Makoto Urushibara ◽  
...  
Keyword(s):  
Back Pain ◽  
Clinical Outcomes ◽  
Japanese Orthopaedic Association ◽  
Large Percentage ◽  
Neutral Position ◽  
Maximal Extension ◽  
Surgical Methods ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Functional Scores ◽  
Lumbar Spondylolisthesis

<sec><title>Study Design</title><p>Retrospective review of prospectively collected outcome data.</p></sec><sec><title>Purpose</title><p>To compare 5-year outcomes following decompression with fusion (FU) and microendoscopic decompression (MED) in patients with degenerative lumbar spondylolisthesis (DLS) and to define surgical indication limitations regarding the use of MED for this condition.</p></sec><sec><title>Overview of Literature</title><p>There have been no comparative studies on mid- or long-term outcomes following FU and MED for patients with DLS.</p></sec><sec><title>Methods</title><p>Forty-one consecutive patients with DLS were surgically treated. Sixteen patients first underwent FU (FU group), and 25 then underwent MED (MED group). The 5-year clinical outcomes following the two surgical methods were compared using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.</p></sec><sec><title>Results</title><p>The degree of improvement (DOI) for social life function was significantly greater in the MED group than in the FU group. Although not statistically significant, DOIs for the other four functional scores were also greater in the MED group than in the FU group. However, patients with a large percentage of slippage in the neutral position might experience limited improvement in low back pain, those with a large percentage of slippage at maximal extension might experience limited improvement in three functional scores, and those with a small intervertebral angle at maximal flexion might have limited improvement in three functional scores after MED for DLS. Therefore, we statistically compared the DOIs between the FU and MED groups regarding the preoperative percentage of slippage in the neutral position among patients with greater than 20% slippage, the preoperative percentage of slippage at maximal extension among patients with greater than 15% slippage, and the intervertebral angle at flexion among patients with angles lesser than −5°; however, there were no statistically significant differences between the two groups.</p></sec><sec><title>Conclusions</title><p>MED is a useful minimally invasive surgical procedure that possibly offers better clinical outcomes than FU for DLS.</p></sec>

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 &lt; .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 &lt; .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.

Biomechanics of Grade I degenerative lumbar spondylolisthesis. Part 2: Treatment with threaded interbody cages/dowels and pedicle screws

2001 ◽  
Vol 94 (1) ◽  
pp. 51-60 ◽  
Author(s):  
Sedat Çagli ◽  
Neil R. Crawford ◽  
Volker K. H. Sonntag ◽  
Curtis A. Dickman
Keyword(s):  
Pedicle Screw ◽  
Degenerative Spondylolisthesis ◽  
Pedicle Screws ◽  
Cyclic Fatigue ◽  
Pedicle Screw Fixation ◽  
Biomechanical Stability ◽  
Content Type ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Fine Print

Object. The authors sought to determine the biomechanical effectiveness of threaded interbody cages or dowels compared with that achieved using pedicle screw instrumentation in resisting Grade I lumbar spine degenerative spondylolisthesis. Methods. Thirty-three levels obtained from seven cadaveric lumbar spines were instrumented with cages or dowels, pedicle screw/rod instrumentation, or both. Entire specimens were loaded with nonconstraining torques. Each level was loaded with anteroposterior shear forces while an optical system was used to measure the specimen's motion at individual levels. Pedicle screw/rods outperformed interbody cages and dowels in treating spondylolisthesis. Cages or dowels alone provided only moderate biomechanical stability, and their effectiveness depended heavily on the integrity of the ligaments and remaining annulus, whereas the success of pedicle screw fixation relied predominantly on the integrity of the bone for solid fixation. Little biomechanical difference was demonstrated between cages and dowels; both devices were susceptible to loosening with cyclic fatigue. Conclusions. Biomechanically, cages or dowels alone were suboptimal for treating lumbar spondylolisthesis, especially compared with pedicle screw/rods. Threaded cages or dowels used together with pedicle screws/rods created the most stable construct.

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