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Minimally Invasive Transforaminal Lumbar Interbody Fusion at L5-S1 through a Unilateral Approach: Technical Feasibility and Outcomes.

Choi WS, Kim JS, Ryu KS, Hur JW, Seong JH - Biomed Res Int (2016)

Bottom Line: The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up.PSR was 88%.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Seoul St. Mary's Hospital, Catholic University, Seoul 06591, Republic of Korea.

ABSTRACT
Background. Minimally invasive spinal transforaminal lumbar interbody fusion (MIS-TLIF) at L5-S1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits. Objective. To determine the clinical and radiological outcomes of MIS-TLIF for treatment of single-level spinal stenosis low-grade isthmic or degenerative spondylolisthesis at L5-S1. Methods. Radiological data and electronic medical records of patients who underwent MIS-TLIF between May 2012 and December 2014 were reviewed. Fusion rate, cage position, disc height (DH), disc angle (DA), disc slope angle, segmental lordotic angle (SLA), lumbar lordotic angle (LLA), and pelvic parameters were assessed. For functional assessment, the visual analogue scale (VAS), Oswestry disability index (ODI), and patient satisfaction rate (PSR) were utilized. Results. A total of 21 levels in 21 patients were studied. DH, DA, SLA, and LLA had increased from their preoperative measures at the final follow-up. Fusion rate was 86.7% (18/21) at 12 months' follow-up. The most common cage position was anteromedial (15/21). The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up. PSR was 88%. Cage subsidence was observed in 33.3% (7/21). Conclusions. The clinical and radiologic outcomes after MIS-TLIF at L5-S1 in patients with spinal stenosis or spondylolisthesis are generally favorable.

No MeSH data available.


Related in: MedlinePlus

a: disc slope angle (DSA), b: disc angle (DA), c: sacral slope (SS), d: pelvic incidence (PI), and e: pelvic tilt (PT).
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fig2: a: disc slope angle (DSA), b: disc angle (DA), c: sacral slope (SS), d: pelvic incidence (PI), and e: pelvic tilt (PT).

Mentions: Disc angle (DA), segmental lordotic angle (SLA), lumbar lordotic angle (LLA), disc slope angle (DSA), and pelvic parameters were also measured in preoperative standing whole spine radiographs. The DA was measured as the angle subtended by lines parallel to the lower endplate of L5 and the upper endplate of S1. DSA was measured as the angle between a horizontal line and a line connecting the midpoints of the anterior and posterior disc spaces on standing whole spine lateral radiographs [15]. LL was measured between the superior endplate of L1 and the upper endplate of the sacrum (Figure 1). As for pelvic parameters, the PI was measured as the angle between the line perpendicular to the sacral plate at its midpoint and the line connecting this point to the axis of the femoral heads. The SS was measured as the angle between the superior plate of S1 and a horizontal line. The PT was measured as the angle between the line connecting the midpoint of the sacral plate to the femoral heads axis and the vertical line (Figure 2) [18, 19]. DA, SLA, LLA, DSA, and pelvic parameters were measured preoperatively, immediately postoperatively, and at each subsequent outpatient follow-up visit at 6 and 12 months in all patients and in additional follow-up images when they were available.


Minimally Invasive Transforaminal Lumbar Interbody Fusion at L5-S1 through a Unilateral Approach: Technical Feasibility and Outcomes.

Choi WS, Kim JS, Ryu KS, Hur JW, Seong JH - Biomed Res Int (2016)

a: disc slope angle (DSA), b: disc angle (DA), c: sacral slope (SS), d: pelvic incidence (PI), and e: pelvic tilt (PT).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940521&req=5

fig2: a: disc slope angle (DSA), b: disc angle (DA), c: sacral slope (SS), d: pelvic incidence (PI), and e: pelvic tilt (PT).
Mentions: Disc angle (DA), segmental lordotic angle (SLA), lumbar lordotic angle (LLA), disc slope angle (DSA), and pelvic parameters were also measured in preoperative standing whole spine radiographs. The DA was measured as the angle subtended by lines parallel to the lower endplate of L5 and the upper endplate of S1. DSA was measured as the angle between a horizontal line and a line connecting the midpoints of the anterior and posterior disc spaces on standing whole spine lateral radiographs [15]. LL was measured between the superior endplate of L1 and the upper endplate of the sacrum (Figure 1). As for pelvic parameters, the PI was measured as the angle between the line perpendicular to the sacral plate at its midpoint and the line connecting this point to the axis of the femoral heads. The SS was measured as the angle between the superior plate of S1 and a horizontal line. The PT was measured as the angle between the line connecting the midpoint of the sacral plate to the femoral heads axis and the vertical line (Figure 2) [18, 19]. DA, SLA, LLA, DSA, and pelvic parameters were measured preoperatively, immediately postoperatively, and at each subsequent outpatient follow-up visit at 6 and 12 months in all patients and in additional follow-up images when they were available.

Bottom Line: The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up.PSR was 88%.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Seoul St. Mary's Hospital, Catholic University, Seoul 06591, Republic of Korea.

ABSTRACT
Background. Minimally invasive spinal transforaminal lumbar interbody fusion (MIS-TLIF) at L5-S1 is technically more demanding than it is at other levels because of the anatomical and biomechanical traits. Objective. To determine the clinical and radiological outcomes of MIS-TLIF for treatment of single-level spinal stenosis low-grade isthmic or degenerative spondylolisthesis at L5-S1. Methods. Radiological data and electronic medical records of patients who underwent MIS-TLIF between May 2012 and December 2014 were reviewed. Fusion rate, cage position, disc height (DH), disc angle (DA), disc slope angle, segmental lordotic angle (SLA), lumbar lordotic angle (LLA), and pelvic parameters were assessed. For functional assessment, the visual analogue scale (VAS), Oswestry disability index (ODI), and patient satisfaction rate (PSR) were utilized. Results. A total of 21 levels in 21 patients were studied. DH, DA, SLA, and LLA had increased from their preoperative measures at the final follow-up. Fusion rate was 86.7% (18/21) at 12 months' follow-up. The most common cage position was anteromedial (15/21). The mean VAS scores for back and leg pain mean ODI scores improved significantly at the final follow-up. PSR was 88%. Cage subsidence was observed in 33.3% (7/21). Conclusions. The clinical and radiologic outcomes after MIS-TLIF at L5-S1 in patients with spinal stenosis or spondylolisthesis are generally favorable.

No MeSH data available.


Related in: MedlinePlus