A prospective, cohort study comparing translaminar screw fixation with transforaminal lumbar interbody fusion and pedicle screw fixation for fusion of the degenerative lumbar spine

2009 ◽  
Vol 91-B (10) ◽  
pp. 1347-1353 ◽  
Author(s):  
D. Grob ◽  
V. Bartanusz ◽  
D. Jeszenszky ◽  
F. S. Kleinstück ◽  
F. Lattig ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lumbar Spine ◽  
Prospective Cohort ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Lumbar Interbody Fusion ◽  
Translaminar Screw Fixation ◽  
Translaminar Screw

Biomechanical comparison of transdiscal fixation and posterior fixation with and without transforaminal lumbar interbody fusion in the treatment of L5–S1 lumbosacral joint

2018 ◽  
Vol 232 (4) ◽  
pp. 371-377 ◽  
Author(s):  
Hakan Özalp ◽  
Mustafa Özkaya ◽  
Onur Yaman ◽  
Teyfik Demir
Keyword(s):  
Pedicle Screw ◽  
Axial Compression ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Posterior Fixation ◽  
Lumbar Interbody Fusion ◽  
Fusion Cage ◽  
Interbody Fusion Cage

Transdiscal screw fixation is generally performed in the treatment of high-grade L5–S1 spondylolisthesis. The main thought of the study is that the biomechanical performances of the transdiscal pedicle screw fixation can be identical to standard posterior pedicle screw fixations with or without transforaminal lumbar interbody fusion cage insertion. Lumbosacral portions and pelvises of 45 healthy lambs’ vertebrae were dissected. Animal cadavers were randomly and equally divided into three groups for instrumentation. Three fixation systems, L5–S1 posterior pedicle screw fixation, L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion, and L5–S1 transdiscal pedicle screw fixation, were generated. Axial compression, flexion, and torsion tests were conducted on test samples of each system. In axial compression, L5–S1 transdiscal fixation was less stiff than L5–S1 posterior pedicle screw fixation with transforaminal lumbar interbody fusion cage insertion. There were no significant differences between groups in flexion. Furthermore, L5–S1 posterior fixation was stiffest under torsional loads. When axial compression and flexion loads are taken into consideration, transdiscal fixation can be alternatively used instead of posterior pedicle screw fixation in the treatment of L5–S1 spondylolisthesis because it satisfies enough stability. However, in torsion, posterior fixation is shown as a better option due to its higher stiffness.

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