TY - JOUR
T1 - Facet Joint Fixation and Anterior, Direct Lateral, and Transforaminal Lumbar Interbody Fusions for Treatment of Degenerative Lumbar Disc Diseases
T2 - Retrospective Cohort Study of a New Minimally Invasive Technique
AU - Belykh, Evgenii
AU - Kalinin, Andrey A.
AU - Martirosyan, Nikolay L.
AU - Kerimbayev, Talgat
AU - Theodore, Nicholas
AU - Preul, Mark C.
AU - Byvaltsev, Vadim A.
N1 - Funding Information:
The authors thank the staff of Neuroscience Publications at Barrow Neurological Institute for their valuable help in preparing and editing the manuscript. Drs. Theodore, Preul, and Belykh are thankful for support from the Barrow Neurological Foundation, the Women's Board of Barrow Neurological Foundation, and the Newsome Chair in Neurosurgery Research held by Dr. Preul.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/6
Y1 - 2018/6
N2 - Background: Anterior, direct lateral, and transforaminal lumbar interbody fusions (ALIF, DLIF, and TLIF) are usually combined with posterior fixation to treat degenerative spinal diseases. Outcomes of ALIF, TLIF, or DLIF combined with a new wedge-shaped interfacet cage plate have not been reported. We assessed early clinical outcomes of patients treated with interbody fusion and facet fixation using a titanium wedge-shaped cage plate. Methods: This retrospective observational cohort study included patients (n = 80) who underwent 1-level interbody fusion and facet joint fixation via ALIF (n = 24) or DLIF (n = 26) with bilateral facet fixation or TLIF with ipsilateral pedicle screws and contralateral facet fixation (n = 30). Duration of surgery, estimated blood loss, pain (visual analog scale), Oswestry Disability Index (ODI) scores, and Macnab score were assessed up to 12 months after surgery. Results: All patients had a significant decrease in pain scores (P < 0.01) and an increase in ODI scores (P < 0.01), without significant differences between treatment groups. Most surgical outcomes were excellent or good (n = 75, 93.8%) with 5 patients (6.2%) having satisfactory outcomes. Within 2 months, all patients returned to their previous work (66, 82.5%) or lighter work (14, 17.5%). Two patients had fusion failure requiring reoperation. Conclusions: Facet fixation with the wedge-shaped cage plate was associated with minimal soft tissue damage and a low level of postoperative pain. ALIF, DLIF, and TLIF combined with this technique showed good early postoperative clinical and radiologic outcomes. Further studies are needed to assess long-term results and compare them with other fusion methods.
AB - Background: Anterior, direct lateral, and transforaminal lumbar interbody fusions (ALIF, DLIF, and TLIF) are usually combined with posterior fixation to treat degenerative spinal diseases. Outcomes of ALIF, TLIF, or DLIF combined with a new wedge-shaped interfacet cage plate have not been reported. We assessed early clinical outcomes of patients treated with interbody fusion and facet fixation using a titanium wedge-shaped cage plate. Methods: This retrospective observational cohort study included patients (n = 80) who underwent 1-level interbody fusion and facet joint fixation via ALIF (n = 24) or DLIF (n = 26) with bilateral facet fixation or TLIF with ipsilateral pedicle screws and contralateral facet fixation (n = 30). Duration of surgery, estimated blood loss, pain (visual analog scale), Oswestry Disability Index (ODI) scores, and Macnab score were assessed up to 12 months after surgery. Results: All patients had a significant decrease in pain scores (P < 0.01) and an increase in ODI scores (P < 0.01), without significant differences between treatment groups. Most surgical outcomes were excellent or good (n = 75, 93.8%) with 5 patients (6.2%) having satisfactory outcomes. Within 2 months, all patients returned to their previous work (66, 82.5%) or lighter work (14, 17.5%). Two patients had fusion failure requiring reoperation. Conclusions: Facet fixation with the wedge-shaped cage plate was associated with minimal soft tissue damage and a low level of postoperative pain. ALIF, DLIF, and TLIF combined with this technique showed good early postoperative clinical and radiologic outcomes. Further studies are needed to assess long-term results and compare them with other fusion methods.
KW - Anterior retroperitoneal lumbar interbody fusion
KW - Direct lateral lumbar interbody fusion
KW - Facet fixation
KW - Facet joint
KW - Intervertebral disc
KW - Posterior lumbar interbody fusion
KW - Spinal fusion
KW - Transforaminal lumbar interbody fusion
KW - Zygapophyseal joint
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U2 - 10.1016/j.wneu.2018.03.121
DO - 10.1016/j.wneu.2018.03.121
M3 - Article
C2 - 29588241
AN - SCOPUS:85045877685
VL - 114
SP - e959-e968
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -