Effects of Lumbar Arthrodesis on Adjacent Segments

Kim, Tae Yup; Kang, Kyoung‐Tak; Yoon, Do Heum; Shin, Hocheol; Kh, Kim; Yi, Seong; Chun, Hye‐Yeong; Oh, Jae Keun; Choi, Gwi Hyun; Lee, Kwang; Ha, Yoon

doi:10.1097/brs.0b013e31824da81d

Cited by 22 publications

(23 citation statements)

References 34 publications

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“…Recently, several studies [3–5] have shown that minimally invasive spinal (MIS) techniques, such as minimally invasive transforaminal interbody fusion (MI-TLIF), offer comparable results with the traditional open TLIF with the benefits of a shorter hospital stay, less blood loss, and shorter recovery time. This approach involves a paramedian incision and uses natural anatomical corridors by means of tubular retractor application, reducing the degree of muscle, fascia, and soft tissue injury compared to conventional open procedures.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion: Clinical and Radiological Results of Mean 46-Month Follow-Up

Lee

Erken

Bae

2017

BioMed Research International

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Background. Spinal fusion has been shown to be the preferred surgical option to reduce pain, recover function, and increase quality of life in the treatment of a variety of lumbar spinal disorders. The main goal of the present study is to report our clinical experience and results of percutaneous transforaminal endoscopic lumbar interbody fusion (PELIF) applications using the expandable spacer in a single institution. Methods. We performed a retrospective review of 18 patients with >12-month follow-up who had been operated on PELIF using expandable spacer from 2001 to 2007. Their clinical and radiological data were collected and analyzed. Results. The mean follow-up period was 46 months. The mean DH before the surgery was 8.3 mm which improved to 11.4 mm at the early postoperative period and regressed to 9.3 mm at the last follow-up visit. The VAS-B, VAS-L, and ODI scores at the last follow-up showed a 54%, 72%, and 69% improvement from the preoperative period, respectively. Conclusions. The presented PELIF technique with the expandable spacer seems to be a promising surgical technique for the treatment of a variety of lumbar spinal disorders. Conversely, radiological results including disc space subsidence make the stand-alone application of the expandable spacer debatable.

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Section: Introductionmentioning

confidence: 99%

Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion: Clinical and Radiological Results of Mean 46-Month Follow-Up

Lee

Erken

Bae

2017

BioMed Research International

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“…It became a popular procedure, causing a shift toward less invasive surgery. Many studies have shown that MIS-TLIF involves less blood loss, has a shorter recovery time, and requires fewer days in the hospital by comparison with open TLIF [9][10][11][12] . However, in addition to MIS-TLIF, partial laminectomy, facetectomy, and ligamentum flavum dissection, an open incision of the musculature is required to reach the vertebrae.…”

Section: Introductionmentioning

confidence: 99%

Early Clinical Results of Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion: A New Modified Technique for Treating Degenerative Lumbar Spondylolisthesis

Nagahama¹,

Ito

Abe

et al. 2019

Spine Surg Relat Res

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Introduction Lumbar interbody fusion is used to treat degenerative lumbar spondylolisthesis with instability. We developed a device that safely expands a percutaneous path through Kambin's triangle and used it via a new technique: percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF). We report in this study the details and outcomes of this procedure after a one year follow-up. Methods Twenty-five patients requiring interbody fusion for degenerative spondylolisthesis of the L4 vertebra were enrolled in this study. The procedure involved percutaneous posterior pedicle screw placement to correct spondylolisthesis. After the exterior of the L5 vertebra superior articular protrusion was shaved with a percutaneous endoscopic drill in order to expand the safe zone, the oval sleeve was inserted through Kambin's triangle and was rotated to expand the disk height and create a path toward the vertebral disk. The interbody cage was inserted against the J-shaped nerve retractor, with the exiting nerve root retracted. Indirect decompression of spinal canal stenosis was expected because the vertebral body spondylolisthesis had been corrected and the interbody distance was expanded. Thus, no direct decompression was performed posterolaterally. Results The mean follow-up period, surgery time, and blood loss were 22.7 months, 125.4 min, and 64.8 mL, respectively. The Japanese Orthopaedic Association score improved from 13.3 to 28.0. The Roland-Morris Disability Questionnaire score improved from 10.3 to 3.3. All items were evaluated both preoperatively and one year postoperatively. Bone fusion was observed one year postoperatively in 22 out of 25 patients. Conclusions These results demonstrate the feasibility and efficacy of PETLIF for treating degenerative lumbar spondylolisthesis. This minimally invasive procedure is useful and has wide applicability. To obtain safe and favorable results, necessary surgical techniques must be mastered, and surgical equipment, including that for neural monitoring, is required.

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“…To validate the intact FE model, we applied the same loading and boundary conditions used by Yamamoto et al in a representative in‐vitro study for validating the FE model , . The boundary and loading conditions and the validation results have been described in detail previously .…”

Section: Methodsmentioning

confidence: 99%

“…To validate the intact FE model, we applied the same loading and boundary conditions used by Yamamoto et al in a representative in-vitro study for validating the FE model. 15,16,[21][22][23] The boundary and loading conditions and the validation results have been described in detail previously. 15,16 To analyze the biomechanical effects, the follower load that 24 The load amount and path were adopted from previous studies.…”

Section: Methodsmentioning

confidence: 99%

Finite element analysis of a ball‐and‐socket artificial disc design to suppress excessive loading on facet joints: A comparative study with ProDisc

Choi

Shin

Kim

2019

Numer Methods Biomed Eng

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Facet arthrosis at surgical level was identified as major complication after total disc replacement (TDR). One of the reasons for facet arthrosis after TDR has been speculated to be the hypermobility of artificial discs. Accordingly, the artificial disc that can constrain the hypermobility of ball‐and‐socket type artificial discs and reduce loading on facet joints is demanded. The proposed artificial disc, which is named as NewPro, was constructed based on the FDA‐approved ProDisc but contained an interlocking system consisting of additional bars and grooves to control the range of motion (ROM) of lumbar spine in all anatomical planes. The three‐dimensional finite element model of L1 to L5 was developed first, and the biomechanical effects were compared between ProDisc and NewPro. The ROM and facet contact force of NewPro were significantly decreased by 42.7% and 14% in bending and by 45.6% and 34.4% in torsion, respectively, compared with the values of ProDisc, thanks to the interlocking system. In addition, the ROM and facet contact force could be selectively constrained by modifying the location of the bars. The proposed artificial disc with the interlocking system was able to constrain the intersegmental rotation effectively and reduce excessive loading on facet joints, although wear and strength tests would be needed prior to clinical applications.

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Effects of Lumbar Arthrodesis on Adjacent Segments

Cited by 22 publications

References 34 publications

Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion: Clinical and Radiological Results of Mean 46-Month Follow-Up

Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion: Clinical and Radiological Results of Mean 46-Month Follow-Up

Early Clinical Results of Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion: A New Modified Technique for Treating Degenerative Lumbar Spondylolisthesis

Finite element analysis of a ball‐and‐socket artificial disc design to suppress excessive loading on facet joints: A comparative study with ProDisc

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