scholarly journals Curative effect of posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease and changes in adjacent segment quantitative score

2018 ◽  
Author(s):  
Yan Zhuang ◽  
Feng Zhou ◽  
Yunqin Zhang ◽  
Zheng Jin
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Degenerative Disease ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Curative Effect ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Quantitative Score

scholarly journals Medium-term effects of Dynesys dynamic stabilization versus posterior lumbar interbody fusion for treatment of multisegmental lumbar degenerative disease

2017 ◽  
Vol 45 (5) ◽  
pp. 1562-1573 ◽  
Author(s):  
Haiting Wu ◽  
Qingjiang Pang ◽  
Guoqiang Jiang
Keyword(s):  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Degenerative Disease ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Medium Term ◽  
Lumbar Degenerative Disease ◽  
Radiographic Outcomes

Objective To compare the medium-term clinical and radiographic outcomes of Dynesys dynamic stabilization and posterior lumbar interbody fusion (PLIF) for treatment of multisegmental lumbar degenerative disease. Methods Fifty-seven patients with multisegmental lumbar degenerative disease underwent Dynesys stabilization (n = 26) or PLIF (n = 31) from December 2008 to February 2010. The mean follow-up period was 50.3 (range, 46–65) months. Clinical outcomes were evaluated using a visual analogue scale (VAS) and the Oswestry disability index (ODI). Radiographic evaluations included disc height and range of motion (ROM) of the operative segments and proximal adjacent segment on lumbar flexion-extension X-rays. The intervertebral disc signal change was defined by magnetic resonance imaging, and disc degeneration was classified by the Pfirrmann grade. Results The clinical outcomes including the VAS score and ODI were significantly improved in both groups at 3 months and the final follow-up, but the difference between the two was not significant. At the final follow-up, the disc height of stabilized segments in both groups was significantly increased; the increase was more notable in the Dynesys than PLIF group. The ROM of stabilized segments at the final follow-up decreased from 6.20° to 2.76° and 6.56° to 0.00° in the Dynesys and PLIF groups, respectively. There was no distinct change in the height of the proximal adjacent segment in the two groups. The ROM of the proximal adjacent segment in both groups increased significantly at the final follow-up; the change was significantly greater in the PLIF than Dynesys group. Only one case of adjacent segment degeneration occurred in the PLIF group, and this patient underwent a second operation. Conclusions Both Dynesys stabilization and PLIF can improve the clinical and radiographic outcomes of multisegmental lumbar degenerative disease. Compared with PLIF, Dynesys stabilization can maintain the mobility of the stabilized segments with less influence on the proximal adjacent segment and may help to prevent the occurrence of adjacent segment degeneration. Dynesys is reliable for the treatment of multisegmental lumbar degenerative disease at the medium-term follow-up.

scholarly journals Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

2020 ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
Shaoyu Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum

Abstract Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group, and into a surgical site infection(SSI)group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.Results: A total of 554 patients were enrolled in the study.The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl and postoperative serum albumin:<3.0 g/dl were significantly related to SWD (P<0.05). There were also significant differences between the surgical site infection(SSI) groups in terms of preoperative serum albumin <3.5 g/dl(P=0.001), postoperative serum albumin <3.5 g/dl (P<0.023) and <3.0 g/dl(P<0.001).Additionally, the increased hospitalization costs and length of hospitalization were statistically significant for patients with perioperative hypoalbuminemia. Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to steroid use, perioperative hypoalbuminemia, which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

Laparoscopic anterior lumbar interbody fusion

1999 ◽  
Vol 7 (6) ◽  
pp. E10 ◽  
Author(s):  
Mark R. McLaughlin ◽  
Jonathan Y. Zhang ◽  
Brian R. Subach ◽  
Regis W. Haid ◽  
Gerald E. Rodts
Keyword(s):  
Interbody Fusion ◽  
Significant Risk ◽  
Posterior Lumbar Interbody Fusion ◽  
Anterior Lumbar Interbody Fusion ◽  
Degenerative Disease ◽  
Laparoscopic Technique ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Level ◽  
Number Of Patients

In recent years, there has been an unprecedented increase in the number of patients undergoing treatment with interbody fusion devices for degenerative disease of the lumbar spine. These devices can be placed either anteriorly or posteriorly. With the advent of minimally invasive surgery and the increasing ability of general surgeons to perform transperitoneal procedures laparoscopically, a new laparoscopic technique has been developed for placing lumbar interbody fusion devices. Although this procedure has some advantages over posterior lumbar interbody fusion, it is not without significant risk, and the learning curve is steep. The authors review a series of 32 consecutive patients who underwent single-level laparoscopic anterior lumbar interbody fusion at L4–5 or L5–S1 over a 2-year period for the treatment of single-level lumbar degenerative disease. In this report they review the technical aspects of the procedure and the important lessons they have learned through their early experience with this technique.

scholarly journals Dynamic Stabilization Adjacent to Fusion versus Posterior Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Xiangyao Sun ◽  
Zhaoxiong Chen ◽  
Siyuan Sun ◽  
Wei Wang ◽  
Tongtong Zhang ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Reoperation Rate ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Hybrid Surgery ◽  
Lumbar Degenerative Disease ◽  
Topping Off

This study evaluated differences in outcome variables between dynamic stabilization adjacent to fusion (DATF) and posterior lumbar interbody fusion (PLIF) for the treatment of lumbar degenerative disease. A systematic review of PubMed, EMBASE, and Cochrane was performed. The variables of interest included clinical adjacent segment pathologies (CASPs), radiological adjacent segment pathologies (RASPs), lumbar lordosis (LL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery (DS), estimated blood loss (EBL), complications, and reoperation rate. Nine articles identified as meeting all of the inclusion criteria. DATF was better than PLIF in proximal RASP, CASP, and ODI during 3 months follow-up, VAS-L. However, no significant difference between DATF and PLIF was found in distal RASP, LL, JOA score, VAS-B, ODI after 3 months follow-up, complication rates, and reoperation rate. These further confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The differences between hybrid surgery and topping-off technique were located in DS and EBL in comparison with PLIF. Our study confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to the fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The difference between hybrid surgery and topping-off technique was not significant in treatment outcomes.

scholarly journals Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

2020 ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
Shaoyu Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum

Abstract Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group, and into a surgical site infection (SSI) group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.Results: A total of 554 patients were enrolled in the study. The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl (P =0.001) and postoperative serum albumin <3.0 g/dl (P =0.001) were significantly correlated to SWD. There were also significant differences between the SSI groups in terms of preoperative serum albumin <3.5 g/dl (P=0.001), Chronic steroid use (P=0.003). Additionally, the increased hospitalization costs (P<0.001) and length of hospitalization (P<0.001) were statistically significant for patients with perioperative hypoalbuminemia. Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to perioperative hypoalbuminemia and chronic steroid use,which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

scholarly journals Perioperative hypoalbuminemia is a risk factor for wound complications following posterior lumbar interbody fusion

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zhongyuan He ◽  
Kai Zhou ◽  
Ke Tang ◽  
Zhengxue Quan ◽  
Shaoyu Liu ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Lumbar Interbody Fusion ◽  
Lumbar Degenerative Disease ◽  
Single Segment ◽  
Preoperative Serum ◽  
Hospitalization Costs ◽  
Postoperative Serum

Abstract Background Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group and into a surgical site infection (SSI) group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses. Results A total of 554 patients were enrolled in the study. The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin < 3.5 g/dl (P = 0.001) and postoperative serum albumin < 3.0 g/dl (P = 0.001) were significantly correlated to SWD. There were also significant differences between the SSI groups in terms of preoperative serum albumin < 3.5 g/dl (P = 0.001) and chronic steroid use (P = 0.003). Additionally, the increased hospitalization costs (P < 0.001) and length of hospitalization (P < 0.001) were statistically significant for patients with perioperative hypoalbuminemia. Conclusions For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to perioperative hypoalbuminemia and chronic steroid use, which are more likely to be associated with increased wound complications, hospitalization costs, and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

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