scholarly journals Outcomes in Combined Anterior and Posterior Fusion for 3- and 4-Level Degenerative Lumbar Disc Disease

2016 ◽  
Vol 9 (3) ◽  
pp. 50-53
Author(s):  
Scott M. Haskins ◽  
Alan Moskowitz ◽  
John J. Lammli ◽  
Eren O. Kuris ◽  
Alexander C.M. Chong

Introduction. This study reported the clinical and functionaloutcomes in a consecutive series of patients with3- or 4-level degenerative disc disease (DDD) betweenvertebral levels L2 to S1, who were treated with combinedanterior lumbar interbody fusion (ALIF) and posteriorspinal fusion at one-year and two-year follow-ups. Methods. A retrospective chart review was performed on allpatients who underwent long segment fusion for DDD by asingle surgeon between August 2002 and January 2012. Fiftyfivepatients were identified and 32 had complete charts for review(14 had one-year follow-up and 18 two-year follow-up).In addition to demographic data, disability (Oswestry DisabilityIndex, ODI), pain level (Visual Analog Scale, VAS), andflexion-extension range-of-motion were measured pre- andpost-operatively. Operative data also were collected, includingoperative time, blood loss, surgical implants used, surgicalapproach, operative levels treated, and complications.Results. Both VAS and ODI improved significantly postoperatively.The average VAS score improved from 6.5 ± 1.5(range: 4 - 9) to 4.4 ± 1.7 (range: 2 - 7) for one-year follow-up,and 7.0 ± 1.8 (range: 4 - 10) to 4.4 ± 2.6 (range: 1 - 9) for twoyearfollow-up. For one-year follow-up, the average ODI scoreimproved from 53 ± 19% (range: 18 - 70%) to 37 ± 17% (range:12 - 64%), and for two-year follow-up, the average improvedfrom 53 ± 18% (range: 18 - 80%) to 31 ± 24% (range: 2 - 92%).The level of improvement in pain and function was similar topreviously published data for 1- and 2-level fusions, but overallpain and function scores were worse in this study group. Conclusions. Arthrodesis for 3- and 4-level DDD is, on average,a successful surgery that shows clinically significantimprovements in function and pain similar to fusionfor 1- and 2-levels with low rates of re-operation. Patientswith involvement of 3- or 4-levels have higher disabilityand pain both pre- and post-operatively compared to shorterfusion level involvement. KS J Med 2016;9(3):50-53.

2018 ◽  
Vol 20 (2) ◽  
pp. 149-156
Author(s):  
Awaiz Ahmed ◽  
Abdulla Jawed ◽  
Murali Venkatesan ◽  
James Doyle

Background. Aim of this prospective study was to evaluate safety and efficacy of second generation Wallis system for degenerative lumbar disc disease. Material and methods. 25 patients underwent discectomy and insertion of Wallis system. Outcome assessment was done using Modified Oswestry disability index (ODI) and visual analogue scale (VAS) for backache and leg pain. Results. The mean follow-up was 20.5 months. The mean VAS for backache and leg pain showed significant improvement from 7.2 to 3.0 (p<0.001) and mean modified Oswestry disability index showed significant improvement from 59.1 to 24.7 (p<0.001). Only one patient (4%) underwent revision surgery for persistent pain due to granulation tissue deep to the implant. There were no other complications. Conclusion. The Wallis spine system is a safe and effective implant for treating degenerative lumbar disc disease.


Spine ◽  
2011 ◽  
Vol 36 (19) ◽  
pp. 1541-1546 ◽  
Author(s):  
Inge Gregersen Sørensen ◽  
Peter Jacobsen ◽  
Finn Gyntelberg ◽  
Poul Suadicani

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
MUSAWER KHAN ◽  
AKRAM ULLAH ◽  
ADNAN AHMED ◽  
MUMTAZ ALI ◽  
MANSOOR AHMAD

Objective:  To determine the outcome of surgical treatment for lumder disc herniation causing the painful incomplete foot drop. Material and Methods:  This retrospective observational study was conducted at the Department of Neurosurgery Lady Reading Hospital, Peshawar. Both Male and female patients with lumbar disc disease causing unilateral incomplete painful foot drop were included in our study. Patients with complete or painless foot drop, bilateral foot-drop, Multiple level disc prolapse, cauda equina syndrome or sciatic neuropathy due to injection injury were excluded. Patients were followed was post-operatively in terms of power in foot dorsiflexion, medical research council (MRC) grade and pain relief  on a Visual Analogue Scale (VAS) after 1 month and then after 6 months. Results: Total number of patients included were 43. Age was ranging from 18 years to 54 years and mean age was 33 years. Before surgery,  power of MRC grade 3 or less, but greater than 1 in dorsiflexion was noted in all patients. The pain was scaled using VAS. Post peratively, at 1 month follow up, the foot-drop improved to MRC grade 4 or 5 along with pain relief of ≥ 2 points on VAS in 81. 4% (n = 35) patients and at 6 month follow-up, the figure rose to 93% (n = 40). Conclusion:  Lumbar disc disease can cause a debilitating foot-drop and pain. Improving or restoring a neurology early surgical intervention has proven benefits.


Sign in / Sign up

Export Citation Format

Share Document