Spondylolisthesis in adults is characterized by the loss of disc height across the affected segment with sagital translation. The goal of stabilizing the spine is accomplished by fusion. Transforaminal approach for lumbar interbody fusion is a very good approach and reduces the complications associated with traditional posterior approach. It has been reported to be safe and effective in the treatment of spondylolisthesis. It has done to assess the functional outcome of Transforaminal Lumbar Interbody Fusion (TLIF) in spondylolisthesis. This prospective interventional study was performed from July 2008 to June 2011 included 30 patients (male 07, female 23), within a age range of 30-59 years. Nineteen cases were lytic, 08 cases were degenerative, 02 were post-traumatic and 01 dysplastic variety of spondylolisthesis. Follow up ranged from 12 to 24 months and outcome assessed by VAS and ODI regarding pain and disability. Achievement of fusion and complications were documented accordingly. Statistical analysis was done by unpaired t-test and chi-squared test in appropriate instances. We included twenty 0ne (70.00%) patient had Grade-II Spondylolisthesis and L 4 over L 5 had been the commonest level (53.33%) involved. Pain and disability improved significantly and 22 (73.33%) patients returned to their previous level of activity. One (03.33%) patient developed superficial wound infection and 01 (03.33%) had persistent low back pain. All patients had neurological improvement. We concluded that Transforaminal Lumbar Interbody Fusion is an effective alternative surgical procedure for the treatment of spondylolisthesis. Overall outcome is satisfactory in 93.33% cases.
This study is to evaluate the clinical and radiological success of posterior decompression, posterolateral fusion and stabilization by pedicle screw and rod in the management of traumatic thoracolumbar fractures. It is a prospective interventional study which is carried out in Bangabandhu Sheikh Mujib Medical University and different private hospitals in Dhaka city from January 2008 to December 2010. Total 16 patients were selected according to the inclusion and exclusion criteria. There were 10 male patients and 06 female within a age range of 21-40 years. Mean age was 33.32 years. Total 08 cases involved L 1 , 03 cases involved at D 12 , 02 cases involved at D 11 and at L 2 each whereas 01 case at L 3 . Total 10 cases were of compression fracture and remainder 06 burst fractures. Ten (10) patients presented with paraparesis, 05 patients with incomplete paraplegia and 01 patient with complete paraplegia. All the patients were followed up for minimum 1 year. Patients with paraparesis fully recovered neurologically and could walk without support. All the 05 patients with incomplete paraplegia also recovered fully except 01 which gained partial improvement and walks with aids. One patient with complete paraplegia remained unchanged. Our results show that posterior decompression posterolateral fusion and stabilization by pedicle screw and rod provides a safe and effective surgical option for management of traumatic thoracolumbar fractures.
IntroductionSpinal fusion offers the surgeon an opportunity to remove the pathologic process, eliminate painful motion and obtain decompression of the neural elements. 1 Fusion is at present the gold standard treatment for herniated cervical discs. Currently, over 95% fusion rate occurs after application of anterior cervical implants 2 . The indications for anterior cervical discectomy
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