Document Detail


Surgical treatment of adult degenerative spondylolisthesis by instrumented transforaminal lumbar interbody fusion in the Han nationality.
MedLine Citation:
PMID:  19442014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The transforaminal lumbar interbody fusion (TLIF) procedure was developed to provide the surgeon with a fusion procedure that may reduce many of the risks and limitations associated with posterior lumbar interbody fusion, yet produce similar stability in the spine. There are few large series with long-term follow-up data regarding instrumented TLIF and placement of 1 diagonal polyetheretherketone (PEEK) cage. The authors performed a prospective study to evaluate the outcome and safety of instrumented TLIF with 1 diagonal PEEK cage for degenerative spondylolisthesis in the Han nationality in China. METHODS: Between May 2001 and April 2006, 60 patients (35 men and 25 women; mean age 55.5 years, range 45-70 years) with symptomatic degenerative spondylolisthesis underwent the TLIF procedure with 1 diagonal PEEK cage and additional pedicle screw internal fixation at the authors' institution. The inclusion criteria involved degenerative spondylolisthesis (Grades I and II) in patients with chronic low-back pain with or without leg pain. RESULTS: One patient had a postoperative temporary motor and sensory deficit of the adjacent nerve root. Reoperation was required in 1 patient because of pedicle screw migration. One patient developed a pseudarthrosis and had increasing complaints of low-back pain 1 year postoperatively and underwent a subsequent revision surgery. Two patients had nerve root symptomatic compression resulting from cage migration and insufficient decompression after surgery, and they underwent revision. Two patients had a dural tear that required fibrin glue application during surgery. No implant fracture or subsidence occurred in any patient. Clinically, the pain index and Oswestry Disability Index (ODI) score improved significantly from before surgery to the 2-year follow-up. In the TLIF group, the pain index improved from 69 to 25 (p < 0.001). The postoperative ODI showed a significant postoperative reduction of disability during the whole period of follow-up (p < 0.001). The preoperative mean ODI score was 32.3 (16-80), and postoperative 13.1 (0-28). Disc space height and foraminal height were restored by the surgery and maintained at the latest follow-up time. CONCLUSIONS: In the authors' experience, instrumented TLIF with 1 diagonal PEEK cage can be a surgical option for treatment of degenerative spondylolisthesis in the Han nationality in China.
Authors:
Hao Xu; Hao Tang; Zhonghai Li
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  10     ISSN:  1547-5654     ISO Abbreviation:  -     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-15     Completed Date:  2009-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  496-9     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics, First Hospital of Wujiang City, Jiangsu Province, PR China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Asian Continental Ancestry Group
China
Female
Humans
Low Back Pain / etiology
Lumbar Vertebrae / surgery*
Male
Middle Aged
Orthopedic Fixation Devices
Postoperative Complications
Prospective Studies
Reoperation
Spinal Fusion / instrumentation,  methods*
Spondylolisthesis / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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