scholarly journals Bending rod is unnecessary in single-level posterior internal fixation and fusion in treatment of lumbar degenerative diseases

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao Han ◽  
Xin Chen ◽  
Kuan Li ◽  
Zheng Li ◽  
Shugang Li
Keyword(s):  
Dynamic Instability ◽  
Lumbar Fusion ◽  
Operating Time ◽  
Sagittal Imbalance ◽  
Degenerative Diseases ◽  
Vertebral Disc ◽  
Lumbar Degenerative Diseases ◽  
Vertebral Degeneration ◽  
Time Point

Abstract Background Bending rod is a routine in lumbar fusion and fixation surgery, but there is no study investigating whether bending rod in one level is necessary. Methods Patients receiving 1 level lumbar fixation and fusion between May 2018 and September 2020 were included with a minimum 6-month follow-up. The routine of bending rod was omitted during fixation. Preoperative and postoperative radiological parameters were compared. Results There were 67 patients included in the study. Segment lordosis angle increased obviously from 10° (1–39°) to 14° (2–30°) immediately after operation (p = 0.000). T5-T12 increased from 22.97 ± 12.31° to 25.52 ± 11.83° by the 3rd months after surgery (p = 0.011). SS decreased from 35.45 ± 10.47 to 32.19 ± 11.37 in 6-month follow-up (p = 0.038), and PI dropped from 56.97 ± 14.24 to 53.19 ± 12.84 (p = 0.016). ROM of SLA decreased from 4.13 ± 3.14° to 1.93 ± 1.87° at that time point (p = 0.028). Those changes were not seen at 12-month follow-up. No evidence of adjacent vertebral disc degeneration was observed at any time point. Conclusions No sagittal imbalance, dynamic instability or adjacent vertebral degeneration was observed by the 12th month after single-segment posterior lumbar fusion with the use of unbent rods. Bending rod could be omitted in 1-level lumbar fusion to simplify the procedure and reduce operating time.

scholarly journals Comparison of the efficacy of MIS-TLIF combined with unilateral or bilateral internal fixation on single-segment lumbar degenerative diseases

2019 ◽  
Vol 17 ◽  
pp. 205873921984439
Author(s):  
Lisheng Zhao ◽  
Huijin Yu ◽  
Yan Zhang ◽  
Wenjun Zhen
Keyword(s):  
Internal Fixation ◽  
Lumbar Lordosis ◽  
Clinical Effects ◽  
Degenerative Diseases ◽  
Single Segment ◽  
Tnf Α ◽  
Significant Difference ◽  
Lumbar Degenerative Diseases ◽  
Serum Crp

In this study, to compare the efficacy of minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) combined with unilateral or bilateral internal fixation for the treatment of single-segment lumbar degenerative diseases, patients with single-segment lumbar degenerative diseases treated with MIS-TLIF combined with unilateral or bilateral internal fixation in Rehabilitation Center, Gansu Province Hospital from January 2014 to November 2015 were retrospectively enrolled, and the related data of 85 patients with 2-year follow-up were obtained. The patients were divided into unilateral group (40 cases) and bilateral group (45 cases) according to the method of internal fixation, and the Oswestry dysfunction index (ODI), visual analogue scale (VAS), lumbar lordosis angle, surgical segmental lordosis angle, lumbar scoliosis angle, surgical segmental scoliosis angle, lumbar lordosis index (LI), intervertebral height index (IHI), fusion rates, and serum inflammatory factors, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor alpha (TNF-α), were calculated to evaluate the efficacy of these two surgical methods. The results showed that the VAS and ODI of the two groups at 1 month, 6 months after surgery, and the last follow-up were significantly improved when compared with those before surgery ( P < 0.05). However, there were no significant differences in VAS and ODI between the two groups at preoperative, 1 month, 6 months after surgery, and the last follow-up ( P > 0.05). The lumbar lordosis and LI decreased at 1 month, 6 months, and the last follow-up ( P < 0.05), while the IHI increased when compared with that before surgery ( P < 0.05). Besides, no significant differences were observed in lumbar lordosis, LI, and IHI between the two groups at preoperative, 1 month, 6 months after surgery, and final follow-up ( P > 0.05). In addition, the fusion rates between these two groups had no significant difference ( P > 0.05). The levels of serum CRP, IL-6, and TNF-α at 12 and 24 h after operation in the two groups were higher than those before operation ( P < 0.05), but there was no significant difference in the levels of serum CRP, IL-6, and TNF-α between the two groups at 12 and 24 h after operation ( P < 0.05). In addition, none of the patients of both groups had permanent nerve injury, incision infection, and other complications. These results showed that MIS-TLIF combined with unilateral or bilateral percutaneous internal fixation technique causes less damage to the body tissues of patients with single-segment lumbar degenerative diseases, and they were considered to have similar clinical effects and imaging.

scholarly journals Hybrid surgery with PEEK rods for lumbar degenerative diseases: a 2-year follow-up study

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Yao Zhao ◽  
Beiyu Xu ◽  
Longtao Qi ◽  
Chunde Li ◽  
Lei Yue ◽  
...  
Keyword(s):  
Lumbar Disc ◽  
Clinical Results ◽  
Adjacent Segment ◽  
Degenerative Diseases ◽  
Hybrid Surgery ◽  
X Ray ◽  
Vas Score ◽  
Peek Rods ◽  
Lumbar Degenerative Diseases

Abstract Background Finite element analyses and biomechanical tests have shown that PEEK rods promote fusion and prevent adjacent segment degeneration. The purpose of this study was to evaluate the effects and complications of hybrid surgery with PEEK rods in lumbar degenerative diseases. Methods From January 2015-December 2017, 28 patients who underwent lumbar posterior hybrid surgery with PEEK rods were included in the study. The patients were diagnosed with lumbar disc herniation, lumbar spinal stenosis, or degenerative grade I spondylolisthesis. Before the operation and at the last follow-up, the patients completed lumbar anteroposterior and lateral X-ray, dynamic X-ray, MRI examinations. In addition, at the last follow-up the patients also completed lumbar CT examinations. The radiographic parameters, clinical visual analog scale (VAS) score and Oswestry disability index (ODI) score were compared. Results The average age of the patients was 44.8 ± 12.6 years, and the average follow-up duration was 26.4 ± 3.6 months. The VAS score improved from 6.3 ± 1.6 to 1.0 ± 0.9, and the ODI score decreased from 38.4 ± 10.8 to 6.8 ± 4.6. The fusion rate of the fused segment was 100%. There were no significant changes in the modified Pfirrmann classifications or disc height index for the nonfused segments and the upper adjacent segments from pre- to postoperatively. No cases of screw loosening, broken screws, broken rods or other mechanical complications were found. Conclusion Hybrid surgery with PEEK rods for lumbar degenerative diseases can yield good clinical results and effectively reduce the incidence of complications such as adjacent segment diseases.

Prevalence of Osteoporosis in Patients Undergoing Lumbar Fusion for Lumbar Degenerative Diseases

Spine ◽  
2020 ◽  
Vol 45 (7) ◽  
pp. E406-E410 ◽  
Author(s):  
Da Zou ◽  
Shuai Jiang ◽  
Siyu Zhou ◽  
Zhuoran Sun ◽  
Woquan Zhong ◽  
...  
Keyword(s):  
Lumbar Fusion ◽  
Degenerative Diseases ◽  
Lumbar Degenerative Diseases ◽  
Prevalence Of Osteoporosis

scholarly journals A Novel Capsule Lumbar Interbody Fusion (CLIF) in Treating Foot Drop due to Lumbar Degenerative Diseases: a Prospective, Observational Study

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Kaiqiang Sun ◽  
Feng Lin ◽  
Jialin Jiang ◽  
Jingchuan Sun ◽  
Jiangang Shi
Keyword(s):  
Lumbar Spine ◽  
Nerve Root ◽  
Interbody Fusion ◽  
Foot Drop ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Degenerative Diseases ◽  
Hemodynamic Parameters ◽  
Lumbar Degenerative Diseases

Objective. This present study aimed to explore the clinical effects of a novel capsule lumbar interbody fusion (CLIF) on foot drop due to lumbar degenerative diseases. Methods. Between June 2018 and January 2019, a total of 27 patients admitted to our department with lumbar degenerative diseases with associated foot drop were prospectively enrolled. Given the selection of surgical technique, patients were divided into traditional TLIF group and CLIF group. We assessed patients’ neurological status using JOA and VAS score, tibialis anterior muscle strength using MMT score, diameter and hemodynamic parameters of the L5 nerve root using intraoperative ultrasonography (IoUS), and related radiological parameters of the lumbar spine. Operation time, blood loss, and surgery-associated complications were also recorded. Results. The median duration of follow-up was 150 (6–1460) months. At the final follow-up, all patients acquired satisfactory improvement of neurological function. However, patients in the CLIF group showed better early recovery of foot drop three months after operation than those in the TLIF group, with 75% excellent rate. In addition, IoUS suggested that the diameter and hemodynamic parameters of the L5 nerve root were improved better in the CLIF group, which may suggest the correlation between the recovery of foot drop and the status of L5 nerve root. No severe complications were encountered with CLIF. Conclusions. Our preliminary study revealed that the axial tension of L5 nerve root may be involved in the pathological mechanism of foot drop. The novel technique of CLIF can shorten the lumbar spine and can be effective and safe for the treatment of foot drop due to lumbar degeneration-related diseases.

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