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Mini-open anterior spine surgery for anterior lumbar diseases.

Lin RM, Huang KY, Lai KA - Eur Spine J (2008)

Bottom Line: Nearly all cases had improved back pain (87%), physical function (90%) and life quality (85%).There were no major complications.Therefore, MOASS is feasible, effective and safe for patients with various anterior lumbar diseases.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, College of Medicine, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 70428, Taiwan. linrm@mail.ncku.edu.tw

ABSTRACT
Minimally invasive surgeries including endoscopic surgery and mini-open surgery are current trend of spine surgery, and its main advantages are shorter recovery time and cosmetic benefits, etc. However, mini-open surgery is easier and less technique demanding than endoscopic surgery. Besides, anterior spinal fusion is better than posterior spinal fusion while considering the physiological loading, back muscle function, etc. Therefore, we aimed to introduce the modified "mini-open anterior spine surgery" (MOASS) and to evaluate the feasibility, effectiveness and safety in the treatment of various anterior lumbar diseases with this technique. A total of 61 consecutive patients (46 female, 15 male; mean age 58.2 years) from 1997 to 2004 were included in this study, with an average follow-up of 24-52 (mean 43) months. The disease entities included vertebral fracture (20), failed back surgery (13), segmental instability or spondylolisthesis (10), infection (8), herniated disc (5), undetermined lesion for biopsy (4), and hemivertebra (1). Lesions involved 13 cases at T12-L1, 18 at L1-L2, 18 at L2-L3, 22 at L3-L4 and 11 at L4-L5 levels. All patients received a single stage anterior-only procedure for their anterior lumbar disease. We used the subjective clinical results, Oswestry disability index, fusion rate, and complications to evaluate our clinical outcome. Most patients (91.8%) were subjectively satisfied with the surgery and had good-to-excellent outcomes. Mean operation time was 85 (62-124) minutes, and mean blood loss was 136 (minimal-250) ml in the past 6 years. Hospital stay ranged from 4-26 (mean 10.6) days. Nearly all cases had improved back pain (87%), physical function (90%) and life quality (85%). Most cases (95%) achieved solid or probable solid bony fusion. There were no major complications. Therefore, MOASS is feasible, effective and safe for patients with various anterior lumbar diseases.

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A 51-year-old female who received the MOASS technique for an old bursting fracture. A mesh stuffed with block allografts was used as the anterior support. Radiography 1 year later showed no loss of correction
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Fig4: A 51-year-old female who received the MOASS technique for an old bursting fracture. A mesh stuffed with block allografts was used as the anterior support. Radiography 1 year later showed no loss of correction

Mentions: Mean disc height gain was 4.76 mm (−2 to 30) with a height loss at follow-up of 2.08 mm (0–10). The average angulation gain was 7.46° (−2 to 45), while further angle loss was 3.69° (0–26) (Table 2). There were 20 neurologically compromised vertebral fractures; most cases could maintain kyphotic correction with only one rod and two screws. The key to this is thought to be adequate interbody support by strut graft, mesh or hybrid (Fig. 4; Table 3).Table 2


Mini-open anterior spine surgery for anterior lumbar diseases.

Lin RM, Huang KY, Lai KA - Eur Spine J (2008)

A 51-year-old female who received the MOASS technique for an old bursting fracture. A mesh stuffed with block allografts was used as the anterior support. Radiography 1 year later showed no loss of correction
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2367411&req=5

Fig4: A 51-year-old female who received the MOASS technique for an old bursting fracture. A mesh stuffed with block allografts was used as the anterior support. Radiography 1 year later showed no loss of correction
Mentions: Mean disc height gain was 4.76 mm (−2 to 30) with a height loss at follow-up of 2.08 mm (0–10). The average angulation gain was 7.46° (−2 to 45), while further angle loss was 3.69° (0–26) (Table 2). There were 20 neurologically compromised vertebral fractures; most cases could maintain kyphotic correction with only one rod and two screws. The key to this is thought to be adequate interbody support by strut graft, mesh or hybrid (Fig. 4; Table 3).Table 2

Bottom Line: Nearly all cases had improved back pain (87%), physical function (90%) and life quality (85%).There were no major complications.Therefore, MOASS is feasible, effective and safe for patients with various anterior lumbar diseases.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, College of Medicine, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 70428, Taiwan. linrm@mail.ncku.edu.tw

ABSTRACT
Minimally invasive surgeries including endoscopic surgery and mini-open surgery are current trend of spine surgery, and its main advantages are shorter recovery time and cosmetic benefits, etc. However, mini-open surgery is easier and less technique demanding than endoscopic surgery. Besides, anterior spinal fusion is better than posterior spinal fusion while considering the physiological loading, back muscle function, etc. Therefore, we aimed to introduce the modified "mini-open anterior spine surgery" (MOASS) and to evaluate the feasibility, effectiveness and safety in the treatment of various anterior lumbar diseases with this technique. A total of 61 consecutive patients (46 female, 15 male; mean age 58.2 years) from 1997 to 2004 were included in this study, with an average follow-up of 24-52 (mean 43) months. The disease entities included vertebral fracture (20), failed back surgery (13), segmental instability or spondylolisthesis (10), infection (8), herniated disc (5), undetermined lesion for biopsy (4), and hemivertebra (1). Lesions involved 13 cases at T12-L1, 18 at L1-L2, 18 at L2-L3, 22 at L3-L4 and 11 at L4-L5 levels. All patients received a single stage anterior-only procedure for their anterior lumbar disease. We used the subjective clinical results, Oswestry disability index, fusion rate, and complications to evaluate our clinical outcome. Most patients (91.8%) were subjectively satisfied with the surgery and had good-to-excellent outcomes. Mean operation time was 85 (62-124) minutes, and mean blood loss was 136 (minimal-250) ml in the past 6 years. Hospital stay ranged from 4-26 (mean 10.6) days. Nearly all cases had improved back pain (87%), physical function (90%) and life quality (85%). Most cases (95%) achieved solid or probable solid bony fusion. There were no major complications. Therefore, MOASS is feasible, effective and safe for patients with various anterior lumbar diseases.

Show MeSH
Related in: MedlinePlus