DOES THE NECESSARY PEDICLE SCREW FIXATION OF THE TLIF PROCEDURE FOR THE FUSION? A RANDOMIZED CLINICAL TRIAL
Journal Title: Journal of Turkish Spinal Surgery - Year 2010, Vol 21, Issue 4
Abstract
Object: Transforaminal lumbar interbody fusion (TLIF) is widely used with pedicular screw fixation. In this comparative randomized study, we aimed to search effect of the instrumentation to clinical results of patient with TLIF. Methods: 60 patients with lumbar degenerative diseases underwent single level TLIF with or without posterior segmental pedicle screw fixation. The Oswestry disability index (ODI) and Visual Analogue Scale (VAS) was used before surgery to the latest evaluation. Fusion was investigated both coronal and sagittal computerized tomography (CT) images. Results: All patients were evaluated after a mean follow-up of 44 +/- 12 months. ODI and VAS scores were both better in Group C, (p < 0.05). Group A patients showed significant changes in back pain (p < 0.05). There was no difference in any score between groups after the 1 year (p > 0.05). The mean preoperative scores of VAS for low back pain for Groups A, B, and C were 6, 6.5, and 5.8, respectively, and decreased after the early surgery to 1.8, 1.5, and 0.6, respectively. The mean preoperative scores of the VAS for leg pain for Groups A, B, and C were 7.1, 7.6, and 6.9, respectively, and decreased after surgery to 2.1, 2.5, and 2.3, respectively. Group C was the cost effective group (p < 0.005). No patient required revision surgery for instrumentation failure and cage displacement in all groups. Delayed hardware failure without asymptomatic 14 months after surgery radiologic pseudarthrosis was observed in 1(5 %) patients in GroupA, in 1(5 %) patient B, and in 2 (10 %)patient in C. There was no adjacent segment degeneration in any spine until the last evaluation. Conclusion: TLIF alone, when compared with TLIF with adjunctive bilateral or unilateral pedicular fixation is a sufficient amount for the fusion and cost effective treatment in lumbar degenerative diseases as a new treatment technique.
Authors and Affiliations
Kadir KOTIL, Ahmet SENGOZ, Güzin OZDEMIR, Yıldıray SAVAS
Keywords
Related Articles
- EP ID EP676661
- DOI -
- Views 91
- Downloads 0
POSTERIOR TRANSPEDICULAR EGG SHELL PROCEDURE AND CONVEX SHORT SEGMENT INSTRUMENTATION FOR CONGENITAL HEMİVERTEBRA
Congenital scoliosis with hemivertebrae is an embriologic, rigid and progressive vertebral abnormality. In this study, evaluation of the clinical data of the congenital hemivertebrae patients who underwent posterior tran...
RESULTS OF SURGICAL INSTRUMENTATION İN ADULT IDIOPATHIC SCOLIOSIS
When compared vvith the adolescent patients surgical treatment of adult idiopathic scoliosis is a challenging problem. İn adults, curves are more rigid and risk of neurologic deficit is higher. İn this study, 23 patients...
THE ALICI SPINAL SYSTEM İN THE SURGICAL TREATMENT OF SCOLIOSIS
The Alıcı spinal system is an instrumentation used for correction and fixation of various of the spine. Idiopathic scoliosis is the most important indication. Scoliosis in a complex deformity in the frontal, sagittal and...
TSRH INSTRUMENTATION İN THE TREATMENT OF UNSTABLE THORACOLUMBAR FRACTURES
The results of 40 patients with unstable thoracolumbar vertebral fractures instrumented surgically by Texas Scottish Rite Hospital (TSRH) System in the 1st Department of Orthopaedics and Traumatology, Ankara Social Secur...
POLIOMYELITIS SCOLIOSIS: THE RESULTS OF SURGICAL TREATMENT
14 patients with the diagnosis of poliomyelitis scoliosis (9 female 5 male) were operated in the Department of Orthopaedics and Traumatology, Faculty of Medicine University of Çukurova Adana, Turkey, betvveen March 1989...