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[Modified transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease].
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Jul; 23(7):788-92.ZX

Abstract

OBJECTIVE

To analyze the clinical effects of modified transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative disease.

METHODS

From October 2003 to December 2006, 33 patients with lumbar degenerative disease (L3-S1) were treated by modified TLIF. There were 14 males and 19 females with an average age of 52.2 years (33 to 70 years). The median disease course was 1.8 years (4 months to 15 years). A total of 42 levels were fused, including 24 cases of single level and 9 cases of double levels. The results of preoperative diagnosis were lumbar degenerative spondylolisthesis with stenosis (8 cases), isthmic spondylolisthesis (5 cases), degenerative lumbar stenosis (16 cases), huge herniated disc with segmental instability (3 cases) and failed back surgery syndrome (1 case). During the modified TLIF procedure, total inferior facet process and inner half summit of superior facet process of TLIF side were resected to make the posterior wall of foramen opened partly. After the bone graft (3 to 5 mL) was placed into the interbody space, a single rectangle Cage was inserted obliquely from 30 degrees to 40 degrees toward the midline. Combined with pedicle screw instrumentation, TLIF was accomplished. Middle canal and opposite side nerve root decompression were performed simultaneously when necessary.

RESULTS

Intraoperative dura mater rupture, postoperative cerebral spinal fluid leakage, deep wound infection and transient nerve root stimulation occurred in 1 case respectively, and were all recovered after treatment. No patients had permanent neurologic deficit or aggravation. All patients were followed up for 20 to 58 months (mean 27.2 months). At the follow-up after 1 year postoperatively, all the operated segments achieved fusion standard and no broken screw or Cage dislocation occurred. All 13 cases of spondylolisthesis were reduced thoroughly and maintained satisfactorily. Nineteen patients remained slight chronic back pain. There was significant difference (P < 0.05) in JOA score between preoperation (14.9 +/- 5.1) and postoperation (25.9 +/- 3.0). The rate of clinical improvement was 80.5% (excellent in 24 cases, good in 7 cases, and fair in 2 cases).

CONCLUSION

The modified TLIF carries out the less invasive principles in opening operations, simplifies the manipulation and expands the indication of TLIF to some extent, and the clinical results for the treatment of lumbar degenerative disease is satisfactory.

Authors+Show Affiliations

Li J
Department of Spine Surgery, Tianjin Hospital, Tianjin, 300211, P.R. China. assenlee@163.com
Deng S
No affiliation info available
Zhao D
No affiliation info available
Zhao H
No affiliation info available
Sun Z
No affiliation info available
Hao Y
No affiliation info available
Ma Y
No affiliation info available

MeSH

AdultAgedFemaleHumansLumbar VertebraeMaleMiddle AgedSpinal DiseasesSpinal FusionSpondylolisthesis

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

19662977

Citation

Li, Jianjiang, et al. "[Modified Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease]." Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, vol. 23, no. 7, 2009, pp. 788-92.
Li J, Deng S, Zhao D, et al. [Modified transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009;23(7):788-92.
Li, J., Deng, S., Zhao, D., Zhao, H., Sun, Z., Hao, Y., & Ma, Y. (2009). [Modified transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, 23(7), 788-92.
Li J, et al. [Modified Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009;23(7):788-92. PubMed PMID: 19662977.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Modified transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease]. AU - Li,Jianjiang, AU - Deng,Shucai, AU - Zhao,Dong, AU - Zhao,Heyuan, AU - Sun,Zhiming, AU - Hao,Yonghong, AU - Ma,Yi, PY - 2009/8/11/entrez PY - 2009/8/11/pubmed PY - 2010/4/2/medline SP - 788 EP - 92 JF - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery JO - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi VL - 23 IS - 7 N2 - OBJECTIVE: To analyze the clinical effects of modified transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative disease. METHODS: From October 2003 to December 2006, 33 patients with lumbar degenerative disease (L3-S1) were treated by modified TLIF. There were 14 males and 19 females with an average age of 52.2 years (33 to 70 years). The median disease course was 1.8 years (4 months to 15 years). A total of 42 levels were fused, including 24 cases of single level and 9 cases of double levels. The results of preoperative diagnosis were lumbar degenerative spondylolisthesis with stenosis (8 cases), isthmic spondylolisthesis (5 cases), degenerative lumbar stenosis (16 cases), huge herniated disc with segmental instability (3 cases) and failed back surgery syndrome (1 case). During the modified TLIF procedure, total inferior facet process and inner half summit of superior facet process of TLIF side were resected to make the posterior wall of foramen opened partly. After the bone graft (3 to 5 mL) was placed into the interbody space, a single rectangle Cage was inserted obliquely from 30 degrees to 40 degrees toward the midline. Combined with pedicle screw instrumentation, TLIF was accomplished. Middle canal and opposite side nerve root decompression were performed simultaneously when necessary. RESULTS: Intraoperative dura mater rupture, postoperative cerebral spinal fluid leakage, deep wound infection and transient nerve root stimulation occurred in 1 case respectively, and were all recovered after treatment. No patients had permanent neurologic deficit or aggravation. All patients were followed up for 20 to 58 months (mean 27.2 months). At the follow-up after 1 year postoperatively, all the operated segments achieved fusion standard and no broken screw or Cage dislocation occurred. All 13 cases of spondylolisthesis were reduced thoroughly and maintained satisfactorily. Nineteen patients remained slight chronic back pain. There was significant difference (P < 0.05) in JOA score between preoperation (14.9 +/- 5.1) and postoperation (25.9 +/- 3.0). The rate of clinical improvement was 80.5% (excellent in 24 cases, good in 7 cases, and fair in 2 cases). CONCLUSION: The modified TLIF carries out the less invasive principles in opening operations, simplifies the manipulation and expands the indication of TLIF to some extent, and the clinical results for the treatment of lumbar degenerative disease is satisfactory. SN - 1002-1892 UR - https://www.unboundmedicine.com/medline/citation/19662977/[Modified_transforaminal_lumbar_interbody_fusion_for_the_treatment_of_lumbar_degenerative_disease]_ L2 - https://medlineplus.gov/spineinjuriesanddisorders.html DB - PRIME DP - Unbound Medicine ER -