Two-Year Comparative Outcomes of MIS Lateral and MIS Transforaminal Interbody Fusion in the Treatment of Degenerative Spondylolisthesis. Part II

Spine ◽  
2016 ◽  
pp. 1 ◽  
Author(s):  
Robert E. Isaacs ◽  
Jonathan Sembrano ◽  
Antoine G. Tohmeh
Keyword(s):  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Transforaminal Interbody Fusion

scholarly journals Best versus worst surgical outcomes after single-level posterior lumbar interbody fusion for degenerative spondylolisthesis

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098303
Author(s):  
Se-Jun Park ◽  
Keun-Ho Lee ◽  
Chong-Suh Lee ◽  
Ki-Tack Kim ◽  
Dong Hyeon Kim ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Degenerative Spondylolisthesis ◽  
Individual Treatment ◽  
Symptom Duration ◽  
Lumbar Interbody Fusion ◽  
Characteristic Analysis ◽  
Single Level ◽  
Patient Reported

Purpose: Previous studies have shown conflicting results regarding the factors affecting the clinical outcome after fusion for degenerative spondylolisthesis. However, no study has compared the best and worst clinical outcome groups using patient-reported outcome measures. We aimed to compare the characteristics of patients with best and worst outcomes following single-level lumbar fusion for degenerative spondylolisthesis. Methods: 200 patients underwent single-level interbody fusion with a minimum 2-years follow-up were included. We excluded patients with surgical complications already-known to be associated with poor postoperative outcomes, including pseudoarthrosis and postoperative infection. According to 2-year postoperative Oswestry disability index scores, patients were divided into two groups; Best and Worst. Demographic, clinical and radiographic variables were compared between the two groups. Results: Compared with patients in the Best group, those in the Worst group were older (59.5 and 67.0 years, respectively; p = 0.012; odds ratio [OR], 1.143; 95% confidence interval [CI], 1.030–1.269) and had a longer duration of pain from onset (2.6 and 7.2 years, respectively; p = 0.041; OR, 1.021; 95% CI, 1.001–1.041). The cutoff value of pain duration from onset was measured as ≥3.5 years on Receiver operating characteristic analysis. Patients in the Worst group had a lower preoperative angular motion compared to those in the Best group (12.7° and 8.3°, respectively; p = 0.016; OR, 0.816; 95% CI, 0.691–0.963). Conclusions: Degenerative spondylolisthesis patients of good clinical outcome after single-level lumbar interbody fusion were relatively young, had a short symptom duration before surgery, and a high preoperative instability compared with the patient having poor postoperative clinical outcome. Therefore, these findings should be considered preoperatively when deciding the appropriate individual treatment plan.

Posterior Lumbar Interbody Fusion Using an En-Bloc Resected Lamina as an Interbody Spacer in Combination with Spinal Instruments

1998 ◽  
Vol 02 (04) ◽  
pp. 325-332
Author(s):  
Shigeru Hirabayashi ◽  
Kiyoshi Kumano ◽  
Takeshi Uchida
Keyword(s):  
Interbody Fusion ◽  
Spinous Process ◽  
Degenerative Spondylolisthesis ◽  
Spinal Instrumentation ◽  
Posterior Lumbar Interbody Fusion ◽  
Bony Union ◽  
Lumbar Interbody Fusion ◽  
En Bloc ◽  
Time Of Operation

We developed a new method of posterior lumbar interbody fusion (PLIF) using an en-bloc resected lamina with or without a hydroxyapatite block as an interbody spacer instead of auto-iliac bone, in combination with rigid-type spinal instrumentation. The purpose of this study was to evaluate the effectiveness of our method. There were 23 patients (13 males, 10 females, age at the time of operation: 21–71 years, mean 50.5 years; follow-up: 1–4 years, mean 2 years and 3 months). In 10 patients with spondylolitic spondylolisthesis and 3 patients with spondylolysis, the floating lamina was resected enbloc by mid-line splitting. In 7 patients with degenerative spondylolisthesis and 3 patients with unstable spine, a cleavage was made at the isthmus and then the complex of lamina and inferior spinous process was resected en-bloc. Seventeen patients with olisthesis underwent reduction. PLIF was performed at the L4/L5 level in 10 patients and the L5/S1 level in 13 patients. Sixteen patients with preoperative low back pain recovered, except for one patient with instability at the adjacent vertebra. All of the seven patients with preoperative gait disturbance recovered. The ratio of olisthesis changed from preoperative 30% to postoperative 18% on average. Good bony union was obtained in both the patients with and those without a hydroxyapatite spacer. Posterior lumbar interbody fusion using an en-bloc resected lamina as an interbody spacer in combination with rigid-type spinal instrumentation was useful.

scholarly journals Posterior fixation can further improve the segmental alignment of lumbar degenerative spondylolisthesis with oblique lumbar interbody fusion

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jingye Wu ◽  
Tenghui Ge ◽  
Ning Zhang ◽  
Jianing Li ◽  
Wei Tian ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Reduction Ratio ◽  
Posterior Fixation ◽  
Lumbar Interbody Fusion ◽  
Slip Ratio ◽  
Radiographic Parameters ◽  
Oblique Lumbar Interbody Fusion ◽  
Lumbar Degenerative Spondylolisthesis ◽  
Segmental Lordosis

Abstract Background For patients with degenerative spondylolisthesis, whether additional posterior fixation can further improve segmental alignment is unknown, compared with stand-alone cage insertion in oblique lumbar interbody fusion (OLIF) procedure. The aim of this study was to compare changes of the radiographical segmental alignment following stand-alone cage insertion and additional posterior fixation in the same procedure setting of OLIF for patients with degenerative spondylolisthesis. Methods A retrospective observational study. Selected consecutive patients with degenerative spondylolisthesis underwent OLIF procedure from July 2017 to August 2019. Five radiographic parameters of disc height (DH), DH-Anterior, DH-Posterior, slip ratio and segmental lordosis (SL) were measured on preoperative CT scans and intraoperative fluoroscopic images. Comparisons of those radiographic parameters prior to cage insertion, following cage insertion and following posterior fixation were performed. Results A total of thirty-three patients including six males and twenty-seven females, with an average age of 66.9 ± 8.7 years, were reviewed. Totally thirty-six slipped levels were assessed with thirty levels at L4/5, four at L3/4 and two at L2/3. Intraoperatively, with only anterior cage support, DH was increased from 8.2 ± 1.6 mm to 11.8 ± 1.7 mm (p < 0.001), DH-Anterior was increased from 9.6 ± 2.3 mm to 13.4 ± 2.1 mm (p < 0.001), DH-Posterior was increased from 6.1 ± 1.9 mm to 9.1 ± 2.1 mm (p < 0.001), the slip ratio was reduced from 11.1 ± 4.6% to 8.3 ± 4.4% (p = 0.020) with the slip reduction ratio 25.6 ± 32.3%, and SL was slightly changed from 8.7 ± 3.7° to 8.3 ± 3.0°(p = 1.000). Following posterior fixation, the DH was unchanged (from 11.8 ± 1.7 mm to 11.8 ± 2.3 mm, p = 1.000), DH-Anterior and DH-Posterior were slightly changed from 13.4 ± 2.1 mm and 9.1 ± 2.1 mm to 13.7 ± 2.3 mm and 8.4 ± 1.8 mm respectively (P = 0.861, P = 0.254), the slip ratio was reduced from 8.3 ± 4.4% to 2.1 ± 3.6% (p < 0.001) with the slip reduction ratio 57.9 ± 43.9%, and the SL was increased from 8.3 ± 3.0° to 10.7 ± 3.6° (p = 0.008). Conclusions Compared with stand-alone cage insertion, additional posterior fixation provides better segmental alignment improvement in terms of slip reduction and segmental lordosis in OLIF procedures in the treatment of lumbar degenerative spondylolisthesis.

Alloplastic or Autologous? Bone Chips versus PEEK Cage for Lumbar Interbody Fusion in Degenerative Spondylolisthesis

2021 ◽  
Author(s):  
Stefan Koehler ◽  
Christopher Held ◽  
Christian Stetter ◽  
Thomas Westermaier
Keyword(s):  
Interbody Fusion ◽  
Posterior Instrumentation ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Peek Cage ◽  
Cheap Alternative ◽  
Autologous Bone ◽  
Group 2 ◽  
Group 1

Abstract Introduction This study was conducted to compare bone-filled intervertebral cages with autologous bone chips for instrumented lumbar interbody fusion in patients with spinal stenosis and degenerative spondylolisthesis. Methods Surgery consisted of posterior instrumentation and decompression, diskectomy, and intervertebral fusion using a polyetheretherketone (PEEK) cage surrounded and filled with spongious bone chips (group 1, n = 57) or spongious bone chips alone (group 2, n = 37). The choice of method was left to the discretion of the surgeon. Postoperative results were prospectively evaluated using a standardized protocol. Radiological assessment included fusion rates and vertebral height, while clinical assessment included the visual analog scale (VAS) and Oswestry Disability Index (ODI). Results In group 1, a mean of 1.38 ± 0.64 segments were fused. In group 2, a mean of 1.58 ± 0.65 segments were fused. In both groups, the VAS for back pain and leg pain and the ODI improved without significant differences between the two groups. Osseous fusion was documented by computerized tomography in 73% in group 1 and 89% in group 2 after a mean of 18 months. The loss of height was 2.8 ± 4.0% in group 1 and 2.4 ± 5.2% in group 2. Conclusion Regardless of whether a PEEK cage filled with spongious bone chips or spongious bone chips alone were used for lumbar interbody fusion, clinical parameters improved significantly after surgery. There were no significant differences in the rate of bony fusion and loss of height between the two groups. The results of this nonrandomized cohort study indicate that the implantation of autologous spongious bone chips harvested during the decompression procedure is a useful and cheap alternative to an intervertebral cage in patients with degenerative pseudospondylolisthesis.

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