Anterior Lumbar Fusion Improves Discogenic Pain at Levels of Prior Posterolateral Fusion

Barrick, William T.; Schofferman, Jerome; Reynolds, James B.; Goldthwaite, Noel; Mckeehen, Michael; Keaney, Diane; White, Arthur H.

doi:10.1097/00007632-200004010-00014

Cited by 139 publications

(76 citation statements)

References 32 publications

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“…Discectomy with fusion has several theoretical advantages. Specifically, interbody fusion reduces or eliminates segmental motion, immobilises the spine, reduces mechanical stresses across the degenerated disc space [1] and may reduce additional herniation at the affected disc space [15]. Lehmann and LaRocca [9] treated 36 patients following previous lumbar surgery by spinal canal exploration and spinal fusion.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Chen

Zhao

Ai-gang

et al. 2008

International Orthopaedics (SICO

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Between 2001 and 2005, 43 patients (average age 54.2, range 36-68 years) with recurrent lumbar disc herniation underwent reoperation with the transforaminal lumbar interbody fusion (TLIF) technique at our unit. All cases were followed up for 24-72 months (mean 45 months) and graded using the Japanese Orthopaedic Association (JOA) score system pre-and post-operation and during the follow-up period. The leg pain of all patients was relieved significantly within one month postoperatively. The mean JOA score was improved from 9.3 before surgery to 25.0 at the final follow-up visit (P<0.0001). The average recovery rate was 86.0% (range 52-100%). General clinical outcome was excellent in 23 (53.5%) patients, good in 14 (32.6%) and fair in 6 (13.9%). The fusion rate was 100% two years postoperatively. Three patients (7%) had transient neurological deficits, which resolved completely within 3 months. There were no major complications. We, therefore, believe the TLIF technique to be an effective procedure with satisfactory clinical results for the treatment of recurrent lumbar disc herniation.Résumé Entre 2001 et 2005, 43 patients (âge moyen 54,2 ans entre 36 à 68 ans) ont bénéficié d'une réintervention chirurgicale avec arthrodèse inter corporéale par technique transforaminale pour récidive de hernie discale lombaire. Tous ces patients ont été suivis en moyenne pendant 45 mois et évalués selon le score de la JOA en pré et post opératoire. Les douleurs des membres de tous ces patients ont été nettement améliorées dans le premier mois post opératoire. Le score de la JOA a été également améliorée de 9,3 avant l'intervention à 25 lors de la dernière revue de ces malades (P<0,0001). Le taux moyen de récupération a été de 86% (52 à 100%). L'évolution clinique générale a été excellente chez 23 patients (53,5%), bonne chez 14 patients (32,6%) et médiocre chez 6 patients (13,9%). Le taux de fusion a été de 100% en post opératoire. 3 patients (7%) ont eu des troubles neurologiques transitoires qui ont complète-ment régressé dans les trois mois. Il n'y a pas eu de complications majeures. L'étude technique TLIF est une technique efficace qui nous donne satisfaction dans le traitement des récidives de hernies discales lombaires.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Chen

Zhao

Ai-gang

et al. 2008

International Orthopaedics (SICO

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“…Fusion is thought to improve back pain by eliminating sources believed to be responsible in back pain including the disc, facet joints and the neural elements. The clinical outcome of lumbar fusions for the treatment of DDD varies widely in the literature [2][3][4][21][22][23][24][25][26]. A meta-analysis comprising 14 studies of instrumented posterolateral fusion combined with an interbody fusion with a minimum of 2-year followup revealed a mean reduction in back pain 49.1% and a mean decrease in ODI scores of 20.6.…”

Section: Discussionmentioning

confidence: 99%

Hybrid construct for two levels disc disease in lumbar spine

et al. 2009

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Prospective study. To study the validity of Hybrid construction (Anterior Lumbar Interbody Fusion) ALIF at one level and total disc arthroplasty (TDA) at adjacent, for two levels disc disease in lumbar spine as surgical strategy. With growing evidence that fusion constructs in the treatment of degenerative disc disease (DDD) may alter sagittal balance and contribute to undesirable complications in the long-term, total disc arthroplasty (TDA) slowly becomes an accepted treatment option for a selected group of patients. Despite encouraging early and intermediate term results of single-level total disc arthroplasty reported in the literature, there is growing evidence that two-level arthroplasty does not fare as well. Hybrid fusion is an attempt to address two-level DDD by combining the advantages of a single-level ALIF with those of a single-level arthroplasty. 42 patients (25 females and 17 males) underwent Hybrid fusion and had a median followup of 26.3 months. The primary functional outcomes were assessed before and after surgery with Oswestry Disability Index and the visual analogue score of the back and legs. Patients were divided into four groups according to the percentage improvement between preop and postop ODI scores. A total of 42 patients underwent a hybrid fusion as follows: 35 L5-S1 ALIF/L4-5 prosthesis, 3 L4-5 ALIF/L3-4 prosthesis, 2 L5-S1 ALIF/L4-5 prosthesis/L3-4 prosthesis, 1 L5-S1 prosthesis/L4-5 ALIF, and 1 L5-S1 ALIF/L4-5 ALIF/L3-4 prosthesis. At 2-years clinical outcomes, mean reduction in ODI is 24.9 points (53.0% improvement compared to preop ODI). The visual analogue score for the back is 64.6% improvement. At 2-year clinical outcomes, Hybrid fusion is a viable surgical alternative for the treatment of two-level DDD in comparison with two-level TDA and with two-level fusion.

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“…Many researchers have reported treating discogenic lower back pain using spinal fusion (1,16). However, it has rarely been reported that discogenic lower back pain has been treated with a non-fusion technique.…”

Section: Comparison Of Preoperative and Postoperative Imaging Measurementioning

confidence: 99%

Experience with the second-generation wallis interspinous dynamic stabilization device implanted in degenerative lumbar disease: a case series of 50 patients

Pan¹,

Zhang²,

Lu³

et al. 2014

Turkish Neurosurgery

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AIm: This study aimed to evaluate the short-to medium-term outcomes of the second-generation Wallis interspinous dynamic stabilization device for treatment of lumbar degenerative disease. mATERIAL and mETHods: Fifty patients with lumbar degenerative disease treated from August 2007 to September 2009 were included in this retrospective study. The Japanese Orthopedic Association (JOA) score and the Oswestry Disability Index (ODI) were used for therapeutic efficacy evaluation. Odom's criteria were used to evaluate postoperative outcome with regard to symptoms. Anteroposterior X-rays were obtained after surgery. All patients were followed up for 2 years. REsuLTs:Based on Odom's criteria, 22, 24 and 4 patients had excellent, good, and fair results respectively. The JOA score at 3, 12, and 24 months after surgery was significantly higher than before surgery (all p <0.001), and the ODI score at 3, 12, and 24 months after surgery was significantly lower than before surgery (all p <0.001). The posterior intervertebral disc height and the neural foramina height at 12 and 24 months after surgery was significantly higher than before surgery (both p <0.001).CoNCLusIoN: Implantation of the second-generation Wallis interspinous dynamic stabilization device produced satisfactory clinical outcome at short-and medium-term follow-up in patients with lumbar degenerative disease.

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Anterior Lumbar Fusion Improves Discogenic Pain at Levels of Prior Posterolateral Fusion

Cited by 139 publications

References 32 publications

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Hybrid construct for two levels disc disease in lumbar spine

Experience with the second-generation wallis interspinous dynamic stabilization device implanted in degenerative lumbar disease: a case series of 50 patients

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