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Erschienen in: Archives of Orthopaedic and Trauma Surgery 9/2011

01.09.2011 | Orthopaedic Surgery

Instrumented transforaminal lumbar interbody fusion with single cage for the treatment of degenerative lumbar disease

verfasst von: Jian Zhou, Bo Wang, Jian Dong, Xilei Li, Xiaogang Zhou, Taolin Fang, Hong Lin

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 9/2011

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Abstract

Introduction

There are several practical problems encountered in the TLIF procedure with implantation of two titanium cages, such as difficulty in achieving symmetric positioning with two cages, loosening of the first cage following insertion of the second cage and higher direct costs to the patient.

Method

From January 2005 to December 2007, a total of 76 consecutive patients treated with instrumented TLIF with single cage and excised local bone were enrolled in the current study. There were 45 males and 31 females aged between 31 and 75 years (mean 50.9 years). Forty-five patients had degenerative disc diseases alone, 23 had associated isthmic or degenerative spondylolisthesis and 8 had recurrent disc herniations. Clinical outcomes were evaluated using the Oswestry Disability Index and a visual analog scale. Intervertebral height and fusion status were assessed on X-ray and two-dimensional computed tomography reconstruction.

Results

All the patients followed up. The mean follow-up period was 21.8 months (range from 12 to 48 months). No nerve injuries occurred during operation. Postoperative ODI and VAS scores in all the patients were more than the preoperative ones with significant differences. All the patients had complete interbody fusion and, at the final follow-up, none had instrumentation failure. Postoperative intervertebral height in all the patients was better than the preoperative ones with statistical significances.

Conclusions

Instrumented TLIF with single cage is a safe and effective method for the treatment of degenerative lumbar diseases.
Literatur
1.
Zurück zum Zitat Blume HG, Rojas CH (1981) Unilateral lumbar interbody fusion (posterior approach) utilizing dowel graft. J Neurol Orthop Surg 2:171–175 Blume HG, Rojas CH (1981) Unilateral lumbar interbody fusion (posterior approach) utilizing dowel graft. J Neurol Orthop Surg 2:171–175
2.
Zurück zum Zitat Harms J, Rolinger H (1982) Die operative Behandlung der Spondylolisthese durch dorsale Aufrichtung und ventrale Verblockung a one-stager procedure in operative treatment of spondylolistheses: dorsal traction–reposition and anterior fusion. Z Orthop Ihre Grenzgeb 120:343–347PubMedCrossRef Harms J, Rolinger H (1982) Die operative Behandlung der Spondylolisthese durch dorsale Aufrichtung und ventrale Verblockung a one-stager procedure in operative treatment of spondylolistheses: dorsal traction–reposition and anterior fusion. Z Orthop Ihre Grenzgeb 120:343–347PubMedCrossRef
3.
Zurück zum Zitat Lauber S, Schulte TL, Liljenqvist U, Harm H, Hackenberg L (2006) Clinical and radiologic 2–4-year results of transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Spine 31:1693–1698PubMedCrossRef Lauber S, Schulte TL, Liljenqvist U, Harm H, Hackenberg L (2006) Clinical and radiologic 2–4-year results of transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Spine 31:1693–1698PubMedCrossRef
4.
Zurück zum Zitat Murakami H, Horton WC, Tomita K, Hutton WC (2004) A two-cage reconstruction versus a single mega-cage reconstruction for lumbar interbody fusion: an experimental comparison. Eur Spine J 13:432–440PubMedCrossRef Murakami H, Horton WC, Tomita K, Hutton WC (2004) A two-cage reconstruction versus a single mega-cage reconstruction for lumbar interbody fusion: an experimental comparison. Eur Spine J 13:432–440PubMedCrossRef
5.
Zurück zum Zitat Kettler A, Schmoelz W, Kast E, Gottwald M, Claes L, Wilke HJ (2005) In vitro stabilizing effect of a transforaminal compared with two posterior lumbar interbody fusion cages. Spine 30:E665–E670PubMedCrossRef Kettler A, Schmoelz W, Kast E, Gottwald M, Claes L, Wilke HJ (2005) In vitro stabilizing effect of a transforaminal compared with two posterior lumbar interbody fusion cages. Spine 30:E665–E670PubMedCrossRef
6.
Zurück zum Zitat Murakami H, Horton WC, Kawahara N, Tomita K, Hutton WC (2001) Anterior lumbar interbody fusion using two standard cylindrical threaded cages, a single mega-cage, or dual nested cages: a biomechanical comparison. J Orthop Sci 6:343–348PubMedCrossRef Murakami H, Horton WC, Kawahara N, Tomita K, Hutton WC (2001) Anterior lumbar interbody fusion using two standard cylindrical threaded cages, a single mega-cage, or dual nested cages: a biomechanical comparison. J Orthop Sci 6:343–348PubMedCrossRef
7.
Zurück zum Zitat Cole CD, McCall TD, Schmidt MH, Dailey AT (2009) Comparison of low back fusion techniques: transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) approaches. Curr Rev Musculoskelet Med 2:118–126PubMedCrossRef Cole CD, McCall TD, Schmidt MH, Dailey AT (2009) Comparison of low back fusion techniques: transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) approaches. Curr Rev Musculoskelet Med 2:118–126PubMedCrossRef
8.
Zurück zum Zitat Hackenberg L, Halm H, Bullmann V, Vieth V, Schneider M, Liljenqvist U (2005) Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results. Eur Spine J 14:551–558PubMedCrossRef Hackenberg L, Halm H, Bullmann V, Vieth V, Schneider M, Liljenqvist U (2005) Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results. Eur Spine J 14:551–558PubMedCrossRef
9.
Zurück zum Zitat Ames CP, Acosta FL, Chi J, Lyengar J, Muiru W, Acaroglu E et al (2005) Biomechanical comparison of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion performed at 1 and 2 levels. Spine 30:E562–E566PubMedCrossRef Ames CP, Acosta FL, Chi J, Lyengar J, Muiru W, Acaroglu E et al (2005) Biomechanical comparison of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion performed at 1 and 2 levels. Spine 30:E562–E566PubMedCrossRef
10.
Zurück zum Zitat Schwender JD, Holly LT, Rouben DP, Foley KT (2005) Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results. J Spinal Disord Tech 18:S1–S6PubMedCrossRef Schwender JD, Holly LT, Rouben DP, Foley KT (2005) Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results. J Spinal Disord Tech 18:S1–S6PubMedCrossRef
11.
Zurück zum Zitat Holly LT, Schwender JD, Roben DP, Foley KT (2006) Minimally invasive transforaminal lumbar interbody fusion: indications, technique, and complications. Neurosurg Focus 20:1–5CrossRef Holly LT, Schwender JD, Roben DP, Foley KT (2006) Minimally invasive transforaminal lumbar interbody fusion: indications, technique, and complications. Neurosurg Focus 20:1–5CrossRef
12.
Zurück zum Zitat Zaveri GR, Mehta SS (2009) Surgical treatment of lumbar tuberculous spondylodiscitis by transforaminal lumbar interbody fusion (TLIF) and posterior instrumentation. J Spinal Disord Tech 22:257–262PubMedCrossRef Zaveri GR, Mehta SS (2009) Surgical treatment of lumbar tuberculous spondylodiscitis by transforaminal lumbar interbody fusion (TLIF) and posterior instrumentation. J Spinal Disord Tech 22:257–262PubMedCrossRef
13.
Zurück zum Zitat Brislin B, Vaccaro AR (2002) Advances in posterior lumbar interbody fusion. Orthop Clin N Am 33:367–374CrossRef Brislin B, Vaccaro AR (2002) Advances in posterior lumbar interbody fusion. Orthop Clin N Am 33:367–374CrossRef
14.
Zurück zum Zitat Humphreys SC, Hodges SD, Patwardhan AG, Eck JC, Murphy RB, Covington LA (2001) Comparison of posterior and transforaminal approaches to lumbar interbody fusion. Spine 26:567–571PubMedCrossRef Humphreys SC, Hodges SD, Patwardhan AG, Eck JC, Murphy RB, Covington LA (2001) Comparison of posterior and transforaminal approaches to lumbar interbody fusion. Spine 26:567–571PubMedCrossRef
15.
Zurück zum Zitat Hee HT, Castro FP, Majd ME, Holt RT, Myers L (2001) Anterior/posterior lumbar fusion versus transforaminal lumbar interbody fusion: analysis of complications and predictive factors. J Spinal Disord Tech 14:533–540CrossRef Hee HT, Castro FP, Majd ME, Holt RT, Myers L (2001) Anterior/posterior lumbar fusion versus transforaminal lumbar interbody fusion: analysis of complications and predictive factors. J Spinal Disord Tech 14:533–540CrossRef
16.
Zurück zum Zitat Matsumura A, Taneichi H, Suda K, Kajino T, Moridaira H, Kaneda K (2006) Comparative study of radiographic disc height changes using two different interbody devices for transforaminal lumbar interbody fusion: open box vs. fenestrated tube interbody cage. Spine 31:E871–E876PubMedCrossRef Matsumura A, Taneichi H, Suda K, Kajino T, Moridaira H, Kaneda K (2006) Comparative study of radiographic disc height changes using two different interbody devices for transforaminal lumbar interbody fusion: open box vs. fenestrated tube interbody cage. Spine 31:E871–E876PubMedCrossRef
17.
Zurück zum Zitat Taneichi H, Suda K, Kajino T, Matsumara A, Moridaira H, Kaneda K (2006) Unilateral transforaminal lumbar interbody fusion and bilateral anterior-column fixation with two Brantigan I/F cages per level: clinical outcomes during a minimum 2-year follow-up period. J Neurosurg Spine 4:198–205PubMedCrossRef Taneichi H, Suda K, Kajino T, Matsumara A, Moridaira H, Kaneda K (2006) Unilateral transforaminal lumbar interbody fusion and bilateral anterior-column fixation with two Brantigan I/F cages per level: clinical outcomes during a minimum 2-year follow-up period. J Neurosurg Spine 4:198–205PubMedCrossRef
18.
Zurück zum Zitat Lowe TG, Tahernia AD, O’Brien MF, Smith DBA (2002) Unilateral transforaminal posterior lumbar interbody fusion (TLIF): indications, technique, and 2-year results. J Spinal Disord Tech 15:31–38PubMedCrossRef Lowe TG, Tahernia AD, O’Brien MF, Smith DBA (2002) Unilateral transforaminal posterior lumbar interbody fusion (TLIF): indications, technique, and 2-year results. J Spinal Disord Tech 15:31–38PubMedCrossRef
19.
Zurück zum Zitat McAfee PC, DeVine JG, Chaput CD, Prybis BG, Fedder IL, Cunningham BW et al (2005) The indications for interbody fusion cages in the treatment of spondylolisthesis: analysis of 120 cases. Spine 30:S60–S65PubMedCrossRef McAfee PC, DeVine JG, Chaput CD, Prybis BG, Fedder IL, Cunningham BW et al (2005) The indications for interbody fusion cages in the treatment of spondylolisthesis: analysis of 120 cases. Spine 30:S60–S65PubMedCrossRef
20.
Zurück zum Zitat Masry EIMA, Khayal H, Salah H (2008) Unilateral transforaminal lumbar interbody fusion (TLIF) using a single cage for treatment of low grade lytic spondylolisthesis. Acta Orthop Belg 74:667–671PubMed Masry EIMA, Khayal H, Salah H (2008) Unilateral transforaminal lumbar interbody fusion (TLIF) using a single cage for treatment of low grade lytic spondylolisthesis. Acta Orthop Belg 74:667–671PubMed
21.
Zurück zum Zitat Mummaneni PV, Haid RW, Rodts GE (2004) Lumbar interbody fusion: state-of-the-art technical advances. J Neurosurg Spine 1:24–30PubMedCrossRef Mummaneni PV, Haid RW, Rodts GE (2004) Lumbar interbody fusion: state-of-the-art technical advances. J Neurosurg Spine 1:24–30PubMedCrossRef
22.
23.
Zurück zum Zitat Biyani A, Rodway I (2007) Breakage and malposition of banana shaped carbon fiber reinforced polymer cage during TLIF procedure. Spine J 7:141–142CrossRef Biyani A, Rodway I (2007) Breakage and malposition of banana shaped carbon fiber reinforced polymer cage during TLIF procedure. Spine J 7:141–142CrossRef
Metadaten
Titel
Instrumented transforaminal lumbar interbody fusion with single cage for the treatment of degenerative lumbar disease
verfasst von
Jian Zhou
Bo Wang
Jian Dong
Xilei Li
Xiaogang Zhou
Taolin Fang
Hong Lin
Publikationsdatum
01.09.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 9/2011
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-011-1292-7

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