Hollow pedicle screw fixation with minimal access-posterior lumbar interbody fusion for lumbar disc herniation

doi:10.3969/j.issn.2095-4344.2014.35.017

Abstract

Abstract:

BACKGROUND: The percutaneous pedicle screw technique effectively reduces the excessive injury of screw placement on paraspinal muscles, and promotes the recovery of the function of low back muscle after surgery. Minimally invasive technique avoids some disadvantages such as large surgical trauma and more bleeding. Folding U-shaped hollow pedicle screw has hollow design and good distraction effect. After fixation, stress intensity, compression time, bending stiffness and torsional mechanical properties have been verified in the clinic.
OBJECTIVE: To observe the clinical effect of folding U-shaped hollow pedicle screw fixation combined with minimal access-posterior lumbar interbody fusion for single-level lumbar disc herniation.
METHODS: Between January and December 2012, folding U-shaped hollow pedicle screw fixation with minimal access-posterior lumbar interbody fusion was performed in 30 patients with lumbar disc herniation. The mean follow-up period was 12 months. Lumbago Visual Analog Scale, Oswestry Disability Index and imaging indicators were utilized to evaluate clinical therapeutic effects.
RESULTS AND CONCLUSION: Preoperative Visual Analog Scale pain score and Oswestry Disability Index for all patients were 7.3±0.7 and 71.4±7.1, 2.9±0.7 and 29.8±3.6 at 3 days after surgery, showing significant differences. At 12 months, no significant difference in Visual Analog Scale pain score and Oswestry Disability
Index was detected. Postoperative short-period follow-up demonstrated that all lumbar interbody fusion was achieved in one year. There was no complication such as implant failure or infection. These findings indicated that folding U-shaped hollow pedicle screw fixation with minimal access-posterior lumbar interbody fusion for lumbar disc herniation showed good clinical therapeutic effects, high rate of interbody fusion and a low rate of complications and small trauma.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: intervertebral disk displacement, internal fixators, surgical procedures, minimally invasive, pain

CLC Number:

R318

Li Cheng-guo, He Er-xing, Ling Qin-jie . Hollow pedicle screw fixation with minimal access-posterior lumbar interbody fusion for lumbar disc herniation[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(35): 5671-5675.

Figures/Tables 2

References

[1] Spoor AB, Oner FC. Minimally invasive spine surgery in chronic low back pain patients. J Neurosurg Sci. 2013;57(3): 203-2118.
[2] Quraishi NA, Rampersaud YR. Minimal access bilateral transforaminal lumbar interbody fusion for high-grade isthmic spondylolisthesis. Eur Spine J. 2013;22(8): 1707-1713.
[3] Cheung NK, Ferch RD, Ghahreman A,et al. Long-term follow-up of minimal-access and open posterior lumbar interbody fusion for spondylolisthesis. Neurosurgery. 2013; 72(3): 443-450; discussion 450-441.
[4] Manjila S, Singer J, Knudson K,et al. Minimally invasive presacral retrieval of a failed AxiaLIF rod implant: technical note and illustrative cases. Spine J. 2012;12(10): 940-948.
[5] Nasca RJ. Newer lumbar interbody fusion techniques. J Surg Orthop Adv. 2013;22(2): 113-117.
[6] Kepler CK, Yu AL, Gruska55y JA,et al. Comparison of open and minimally invasive techniques for posterior lumbar instrumentat6ion and fusion after open anterior lumbar interbody fusion. Spine J. 2013;13(5): 489-497.
[7] Silvestre C, Mac-Thiong JM, Hilmi R,et al. Complications and Morbidities of Mini-open Anterior Retroperitoneal Lumbar Interbody Fusion: Oblique Lumbar Interbody Fusion in 179 Patients. Asian Spine J. 2012;6(2): 89-97.
[8] Kok D, Grevitt M, Wapstra F,et al. The Memory Metal Spinal System in a Posterior Lumbar Interbody Fusion (PLIF) Procedure: A Prospective, Non-Comparative Study to Evaluate the Safety and Performance. Open Orthop J. 2012;6: 220-225.
[9] Massicotte E. The role of minimally invasive techniques in the management of spinal neoplastic disease: a review. J Neurosurg Sci. 2013;57(3): 193-201.
[10] Almenawer SA, Crevier L, Murty N,et al. Minimal access to deep intracranial lesions using a serial dilatation technique: case-series and review of brain tubular retractor systems. Neurosurg Rev. 2013;36(2): 321-329; discussion 329-330.
[11] Schwartz Z, Raz P, Zhao G, et al. Effect of micrometer-scale roughness of the surface of Ti6Al4V pedicle screws in vitro and in vivo. J Bone Joint Surg Am. 2008;90(11):2485-2498.
[12] Moon BJ, Cho BY, Choi EY, et al. Polymethylmethaerylate- augmented screw fixation for stabilization of the osteoporotic spine: a three-year follow-up of 37 patients. J Korean Neurosurg Soc. 2009;46(4):305-311.
[13] 王春,陈少坚.经皮长U形空心椎弓根钉系统治疗胸腰椎骨折的生物力学研究[J].中华创伤骨科杂志,2012,14(7):595-560.
[14] 王春,林永绥,刘清平,等. 经皮长尾可折U形空心椎弓根钉系统固定治疗胸腰椎骨折的疗效评估[J].中国脊柱脊髓杂志,2012, 22(7):627-633.
[15] Jung HJ, Kim SW, Ju CI, et al. Bone cement-augmented short segment fixation with percutaneous screws for thoracolumbar burst fractures accompanied by severe osteoporosis. J Korean Neurosurg Soc. 2012;52(4):353-358.
[16] Korovessis P, Repantis T, Petsinis G, et al. Direct reduction of thoracolumbar burst fractures by means of balloon kyphoplasty with calcium phosphate and stabilization with pedicle-screw instrumentation and fusion. Spine (Phila Pa 1976). 2008;33(4):E100-108.
[17] Lubansu A, Rynkowski M, Abeloos L, et al. Minimally invasive spinal arthrodesis in osteoporotic population using a cannulated and fenestrated augmented screw: technical description and clinical experience. Minim Invasive Surg. 2012;2012:507826.
[18] Magerl FP. Stabilization of the lower thoracic and lumbar spine with external skeletal fixation. Clin Orthop Relat Res. 1984;(189):125-141.
[19] Mathews HH, Long BH. Endoscopy assisted percutaneous anterior interbody fusion with subcutaneous suprafascial internal fixation: evolution for technique and surgical considerations.Orthop Int Ed. 1995;3:946.
[20] Foley KT, Gupta SK. Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results. J Neurosurg. 2002; 97:7 12.
[21] Park Y, Ha JW. Comparison of one level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine. 2007;32: 537-543.
[22] Kasis AG, Marshman LA, Krishna M, et al. Significantly improved outcomes with a less invasive posterior lumbar interbody fusion incorporating total facetectomy. Spine (Phila Pa 1976). 2009; 34(6):572-577.
[23] 刘瑶瑶,代飞,孙东,等. 不同量骨水泥强化新型空心椎弓根螺钉的体外生物力学研究[J]. 第三军医大学学报,2012,34(16): 1626-1629.
[24] Waits C, Burton D, McIff T. Cement augmentation of pedicle screw fixation using novel cannulated cement insertion device. Spine (Phila Pa 1976). 2009;34(14):E478-483.
[25] Pesenti S, Blondel B, Peltier E, et al. Percutaneous cement-augmented screws fixation in the fractures of the aging spine: is it the solution? Biomed Res Int. 2014;2014: 610675.