Facet Joint Fixation and Anterior, Direct Lateral, and Transforaminal Lumbar Interbody Fusions for Treatment of Degenerative Lumbar Disc Diseases: Retrospective Cohort Study of a New Minimally Invasive Technique

Evgenii Belykh, Andrey A. Kalinin, Nikolay L. Martirosyan, Talgat Kerimbayev, Nicholas Theodore, Mark C. Preul, Vadim A. Byvaltsev

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)e959-e968
JournalWorld neurosurgery
Volume114
DOIs
StatePublished - Jun 2018
Externally publishedYes

Keywords

  • Anterior retroperitoneal lumbar interbody fusion
  • Direct lateral lumbar interbody fusion
  • Facet fixation
  • Facet joint
  • Intervertebral disc
  • Posterior lumbar interbody fusion
  • Spinal fusion
  • Transforaminal lumbar interbody fusion
  • Zygapophyseal joint

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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