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Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study.
J Neurosurg Spine. 2016 Nov; 25(5):591-595.JN

Abstract

OBJECTIVE

Several biomechanical studies have demonstrated the favorable mechanical properties of the cortical bone trajectory (CBT) screw. However, no reports have examined surgical outcomes of posterior lumbar interbody fusion (PLIF) with CBT screw fixation for degenerative spondylolisthesis (DS) compared with those after PLIF using traditional pedicle screw (PS) fixation. The purposes of this study were thus to elucidate surgical outcomes after PLIF with CBT screw fixation for DS and to compare these results with those after PLIF using traditional PS fixation.

METHODS

Ninety-five consecutive patients underwent PLIF with CBT screw fixation for DS (CBT group; mean followup 35 months). A historical control group consisted of 82 consecutive patients who underwent PLIF with traditional PS fixation (PS group; mean follow-up 40 months). Clinical status was assessed using the Japanese Orthopaedic Association (JOA) scale score. Fusion status was assessed by dynamic plain radiographs and CT. The need for additional surgery and surgery-related complications was also evaluated.

RESULTS

The mean JOA score improved significantly from 13.7 points before surgery to 23.3 points at the latest follow-up in the CBT group (mean recovery rate 64.4%), compared with 14.4 points preoperatively to 22.7 points at final follow-up in the PS group (mean recovery rate 55.8%; p < 0.05). Solid spinal fusion was achieved in 84 patients from the CBT group (88.4%) and in 79 patients from the PS group (96.3%, p > 0.05). Symptomatic adjacent-segment disease developed in 3 patients from the CBT group (3.2%) compared with 9 patients from the PS group (11.0%, p < 0.05).

CONCLUSIONS

PLIF with CBT screw fixation for DS provided comparable improvement of clinical symptoms with PLIF using traditional PS fixation. However, the successful fusion rate tended to be lower in the CBT group than in the PS group, although the difference was not statistically significant between the 2 groups.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo; and.Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo; and.Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Osaka, Japan.Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo; and.Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo; and.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27231813

Citation

Sakaura, Hironobu, et al. "Posterior Lumbar Interbody Fusion With Cortical Bone Trajectory Screw Fixation Versus Posterior Lumbar Interbody Fusion Using Traditional Pedicle Screw Fixation for Degenerative Lumbar Spondylolisthesis: a Comparative Study." Journal of Neurosurgery. Spine, vol. 25, no. 5, 2016, pp. 591-595.
Sakaura H, Miwa T, Yamashita T, et al. Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study. J Neurosurg Spine. 2016;25(5):591-595.
Sakaura, H., Miwa, T., Yamashita, T., Kuroda, Y., & Ohwada, T. (2016). Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study. Journal of Neurosurgery. Spine, 25(5), 591-595.
Sakaura H, et al. Posterior Lumbar Interbody Fusion With Cortical Bone Trajectory Screw Fixation Versus Posterior Lumbar Interbody Fusion Using Traditional Pedicle Screw Fixation for Degenerative Lumbar Spondylolisthesis: a Comparative Study. J Neurosurg Spine. 2016;25(5):591-595. PubMed PMID: 27231813.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study. AU - Sakaura,Hironobu, AU - Miwa,Toshitada, AU - Yamashita,Tomoya, AU - Kuroda,Yusuke, AU - Ohwada,Tetsuo, Y1 - 2016/05/27/ PY - 2016/11/2/pubmed PY - 2017/2/15/medline PY - 2016/5/28/entrez KW - ASD = adjacent-segment disease KW - CBT = cortical bone trajectory KW - DS = degenerative spondylolisthesis KW - EBL = estimated blood loss KW - JOA = Japanese Orthopaedic Association KW - PLIF = posterior lumbar interbody fusion KW - PS = pedicle screw KW - TLIF = transforaminal lumbar interbody fusion KW - adjacent segment pathology KW - cortical bone trajectory screw technique KW - degenerative lumbar spondylolisthesis KW - posterior lumbar interbody fusion KW - surgical outcome KW - traditional PS technique SP - 591 EP - 595 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 25 IS - 5 N2 - OBJECTIVE Several biomechanical studies have demonstrated the favorable mechanical properties of the cortical bone trajectory (CBT) screw. However, no reports have examined surgical outcomes of posterior lumbar interbody fusion (PLIF) with CBT screw fixation for degenerative spondylolisthesis (DS) compared with those after PLIF using traditional pedicle screw (PS) fixation. The purposes of this study were thus to elucidate surgical outcomes after PLIF with CBT screw fixation for DS and to compare these results with those after PLIF using traditional PS fixation. METHODS Ninety-five consecutive patients underwent PLIF with CBT screw fixation for DS (CBT group; mean followup 35 months). A historical control group consisted of 82 consecutive patients who underwent PLIF with traditional PS fixation (PS group; mean follow-up 40 months). Clinical status was assessed using the Japanese Orthopaedic Association (JOA) scale score. Fusion status was assessed by dynamic plain radiographs and CT. The need for additional surgery and surgery-related complications was also evaluated. RESULTS The mean JOA score improved significantly from 13.7 points before surgery to 23.3 points at the latest follow-up in the CBT group (mean recovery rate 64.4%), compared with 14.4 points preoperatively to 22.7 points at final follow-up in the PS group (mean recovery rate 55.8%; p < 0.05). Solid spinal fusion was achieved in 84 patients from the CBT group (88.4%) and in 79 patients from the PS group (96.3%, p > 0.05). Symptomatic adjacent-segment disease developed in 3 patients from the CBT group (3.2%) compared with 9 patients from the PS group (11.0%, p < 0.05). CONCLUSIONS PLIF with CBT screw fixation for DS provided comparable improvement of clinical symptoms with PLIF using traditional PS fixation. However, the successful fusion rate tended to be lower in the CBT group than in the PS group, although the difference was not statistically significant between the 2 groups. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/27231813/Posterior_lumbar_interbody_fusion_with_cortical_bone_trajectory_screw_fixation_versus_posterior_lumbar_interbody_fusion_using_traditional_pedicle_screw_fixation_for_degenerative_lumbar_spondylolisthesis:_a_comparative_study_ L2 - https://thejns.org/doi/10.3171/2016.3.SPINE151525 DB - PRIME DP - Unbound Medicine ER -