Minimally invasive spinal fusion technique in patients with lumbar segmental instability.

Abstract

Background: Lumbar spinal fusion is a common surgical procedure for treatment of lower back pain caused by degeneration of lumbar disc. The aim of fusion is to prevent motion in the destabilized segments to decrease the low back pain. A modified interspinous device can provide stabilization similar to pedicular screw fixation avoiding its complication when used for interbody fusion as a minimally invasive procedur. Aim of work is to investigate using a new fusion technique, consist of trans-foraminal inter-body placement of peek cage and interspinous stabilization by rigid interspinous device which could provide stabilization of the posterior spinal elements similar to pedicle screw fixation as a minimally invasive procedure. Patient and Methods: The study involved 20 patients with signs of moderate segmental instability in lumbar spine .Transforaminalinterbody fusion using the polyethere-therketone(PEEK)cage and rigid interspinous device fixation was performed. Patients were followed up and treatment outcomes were assessed within approximately 24 months after surgery. Results: According to pain intensity level on the visual analogue scale, the need for painkillers and the quality of life according to the Oswestry Disability Index scale during the early postoperative period demonstrated significantly better outcomes due to a less severe operative trauma to the paravertebral soft tissues. The formation of interbody bone formation was observed after 20-36 months in 94% of patients. Postoperative complications occurred in 2.2% of patient. Conclusion: The use of transforaminalinterbody fusion and rigid interspinous stabilization provides better clinical outcomes and fewer postoperative complications in patients with moderate lumbar segmental instability.