CT-Guided Posterior Lumbar Interbody Fusion and Distraction

2011 ◽  
Vol 24 (6) ◽  
pp. 919-923 ◽  
Author(s):  
L. Manfré
Keyword(s):  
Interbody Fusion ◽  
Sagittal Plane ◽  
Screw Fixation ◽  
Posterior Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Surgical Time ◽  
Ct Guided

We performed CT-guided posterior interbody fusion (PIF) with pedicle screw fixation and distraction to treat degenerative lumbar L4-L5 spondylolisthesis with severe left sciatica. The patient was suffering from L4 nerve root compression related to neural foramina stenosis. The dedicated tools to perform a CT-guided percutaneous PIF technique are described. The procedure was easy to apply with a total surgical time of 90 minutes. The neural foramina were investigated by CT scan reconstruction on sagittal plane demonstrating marked widening after PIF application. The left leg pain completely disappeared in two weeks and the patient remained painless at the three month follow-up control. To our knowledge, there are no other papers on CT-guided PIF procedure in the literature.

scholarly journals Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study

2016 ◽  
Vol 25 (5) ◽  
pp. 591-595 ◽  
Author(s):  
Hironobu Sakaura ◽  
Toshitada Miwa ◽  
Tomoya Yamashita ◽  
Yusuke Kuroda ◽  
Tetsuo Ohwada
Keyword(s):  
Cortical Bone ◽  
Pedicle Screw ◽  
Surgical Outcomes ◽  
Recovery Rate ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Cortical Bone Trajectory

OBJECTIVE Several biomechanical studies have demonstrated the favorable mechanical properties of the cortical bone trajectory (CBT) screw. However, no reports have examined surgical outcomes of posterior lumbar interbody fusion (PLIF) with CBT screw fixation for degenerative spondylolisthesis (DS) compared with those after PLIF using traditional pedicle screw (PS) fixation. The purposes of this study were thus to elucidate surgical outcomes after PLIF with CBT screw fixation for DS and to compare these results with those after PLIF using traditional PS fixation. METHODS Ninety-five consecutive patients underwent PLIF with CBT screw fixation for DS (CBT group; mean followup 35 months). A historical control group consisted of 82 consecutive patients who underwent PLIF with traditional PS fixation (PS group; mean follow-up 40 months). Clinical status was assessed using the Japanese Orthopaedic Association (JOA) scale score. Fusion status was assessed by dynamic plain radiographs and CT. The need for additional surgery and surgery-related complications was also evaluated. RESULTS The mean JOA score improved significantly from 13.7 points before surgery to 23.3 points at the latest follow-up in the CBT group (mean recovery rate 64.4%), compared with 14.4 points preoperatively to 22.7 points at final follow-up in the PS group (mean recovery rate 55.8%; p < 0.05). Solid spinal fusion was achieved in 84 patients from the CBT group (88.4%) and in 79 patients from the PS group (96.3%, p > 0.05). Symptomatic adjacent-segment disease developed in 3 patients from the CBT group (3.2%) compared with 9 patients from the PS group (11.0%, p < 0.05). CONCLUSIONS PLIF with CBT screw fixation for DS provided comparable improvement of clinical symptoms with PLIF using traditional PS fixation. However, the successful fusion rate tended to be lower in the CBT group than in the PS group, although the difference was not statistically significant between the 2 groups.

Clinical outcomes and complications associated with pedicle screw fixation—augmented lumbar interbody fusion

2004 ◽  
Vol 1 (3) ◽  
pp. 261-266 ◽  
Author(s):  
Dennis J. Rivet ◽  
David Jeck ◽  
James Brennan ◽  
Adrian Epstein ◽  
Carl Lauryssen
Keyword(s):  
Carbon Fiber ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Lumbar Interbody Fusion ◽  
Content Type ◽  
Repeated Surgery ◽  
Fine Print

Object. The authors conducted a prospective study to evaluate the clinical and radiological outcomes and complications associated with uni- and bilateral transforaminal lumbar interbody fusion (TLIF) performed using carbon fiber Brantigan I/F Cages and pedicle screw fixation. Methods. Forty-two consecutive patients who had undergone uni- or bilateral TLIF between February 1999 and July 2000 were prospectively evaluated. Clinical outcome was graded using a modified Prolo Scale, the McGill Pain Index Scale, a follow-up questionnaire, and charts. An independent radiologist assessed radiological outcomes. All patients were followed for at least 1 year. Based on Prolo Scale scores, an excellent or good 1-year outcome was achieved in 73% of patients; 90% of patients responded that they would undergo the procedure again. At 1 year, radiographic fusion was demonstrated in 74% and was statistically related to clinical outcome (p < 0.05). There were no deaths or major hardware failures. Complications requiring repeated surgery included one case of cerebrospinal fluid (CSF) leakage and one case in which the hemovac drain was retained. There were four cases involving minor wound infections, eight involving CSF leaks, and none requiring repeated surgery. On routine follow-up radiography one pedicle screw was found to be broken; the patient remained asymptomatic and fusion occurred. Conclusions. Unilateral and bilateral TLIF involving placement of carbon fiber cages and pedicle screw fixation are effective treatment options in patients with indications for lumbar arthrodesis. The procedures result in acceptable rates of fusion and clinical success, and a minimal incidence of morbidity when performed by an experienced surgeon.

Posterior Lumbar Interbody Fusion: With and Without Pedicle Screw Fixation

1993 ◽  
pp. 188-196 ◽  
Author(s):  
Sadaaki Nakai ◽  
Hidezo Yoshizawa ◽  
Kazuhiko Kenmotsu ◽  
Satoshi Nishimoto ◽  
Tomofumi Morita
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Posterior Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Lumbar Interbody Fusion
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