Radiological and clinical comparison of posterolateral fusion and transforaminal interbody fusion techniques in degenerative lumbar stenosis

Yükleniyor...
Küçük Resim

Tarih

2018

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

Elsevier Science Inc

Erişim Hakkı

info:eu-repo/semantics/closedAccess

Özet

OBJECTIVE: Fusion surgery for lumbar degenerative stenosis is an established treatment mode. Despite comparable patient-related outcomes and radiologic results, the necessity of adding interbody fusion to posterolateral fusion remains controversial. We aimed to compare the clinical and radiologic outcomes of posterolateral fusion and transforaminal interbody fusion techniques in degenerative lumbar stenosis with or without spondylolisthesis. METHODS: We retrospectively evaluated the clinical and radiologic outcomes of 48 patients who underwent decompression plus either posterolateral fusion (PLF; n = 23) or transforaminal interbody fusion (TLIF) plus PLF (TLIF+PLF; n = 25) procedures, which incorporated 71 segments for degenerative lumbar stenosis with or without spondylolisthesis. RESULTS: The median follow-up duration for the PLF and TLIF groups were 26 and 31 months, respectively. Both procedures significantly improved the Oswestry Disability Index (ODI) and visual analog scale (VAS) scores; however, the postoperative ODI and VAS scores were unaffected by the procedure type. Postoperative disc heights and percent changes in disc heights did not change by operation type; however, the percent change in the foramen areas was significantly greater in the TLIF group. The addition of TLIF to the PLF procedure resulted in significantly longer operating time and more intraoperative blood loss. Cerebrospinal fluid fistula was the only major complication noted. The radiologic fusion rates were similar between both study groups. CONCLUSIONS: Both PLF and TLIF+PLF procedures were effective in ameliorating the symptoms of degenerative lumbar stenosis and spondylolisthesis. Although some radiologic parameters favor TLIF, this was not reflected in the clinical outcomes.

Açıklama

Anahtar Kelimeler

Degenerative Lumbar Stenosis, Degenerative Spondylolisthesis, Posterolateral Fusion, Transforaminal Lumbar Interbody Fusion

Kaynak

World Neurosurgery

WoS Q Değeri

Q3

Scopus Q Değeri

Q2

Cilt

116

Sayı

Künye

Bozkurt, G., Isikay, I., & Hanalioglu, S. (2018). Radiological and Clinical Comparison of Posterolateral Fusion and Transforaminal Interbody Fusion Techniques in Degenerative Lumbar Stenosis. World Neurosurgery, 116, e1060–e1065. https://doi.org/10.1016/j.wneu.2018.05.165