MIDDLE TERM RESULTS OF MINIMALLY INVASIVE UNILATERAL PEDICLE SCREW FIXATION COMBINED WITH TRANSFORAMINAL INTERBODY FUSION FOR THE TREATMENT OF ONE LEVEL DEGENERATIVE DISC DISEASE IN THE LUMBAR SPINE
Conference: EUROSPINE Meetings 2018At: BARCELONA
MIDDLE TERM RESULTS OF MINIMALLY INVASIVE UNILATERAL PEDICLE SCREW FIXATION COMBINED WITH TRANSFORAMINAL INTERBODY FUSION FOR THE TREATMENT OF ONE LEVEL DEGENERATIVE DISC DISEASE IN THE LUMBAR SPINE
Purpose: The aim of this study was to evaluate the efficacy, safety, clinical results and fusion rate of a minimal invasive unilateral pedicle screw fixation combined with a trasforaminal intebody fusion for the treatment of symptomatic one level degenerative disc disease of the lumbar spine causing radicular leg and back pain. Methods retrospective study: Sample The data of 50 patients (24 Male and 26 Female) that underwent one level minimally invasive unilateral pedicle screw fixation with transforaminal interbody fusionfrom August 2012 to August 2016 by the senior author were retro- spectively evaluated. The mean age of the patients was 56, 42 (34–84 years). The side that the pedicle screws were placed was the ipsilateral side of the leg pain and that was also the side where decompression was performed. Fusion was performed at the L3/4 level in 2 cases, L4/5 in 26 cases and at the L5/S1 level in 22 cases. All the patients had MRI scans of the lumbar spine and standing x rays AP and LAT views of the lumbar spine preoperatively. The approach was right sided in 29 cases and left sided in 21 cases. The primary outcomes were patient related outcome scores Visual Analog Score (VAS) for leg and back pain and Oswestry Disability Index (ODI)at regular Follow Ups at 3, 6, 12 and 24 months. Also the fusion rate was evaluated on plane x rays and CT scans. The mean follow up was 26, 6 months (ranging from 24–62 months). Results Out of the 50 cases there has been one case of migration of the interbody cage which was removed and pedicle screws were placed on the contralateral side and one case of deep wound infection which was treated with removal of the pedicle screws and antibiotic with preservation of the interbody cage. No dural tear or neurological complication was noted. VAS score for Leg pain and Back pain has improved at 3 months postop and remained better compared to preop at 6, 12 and 24 months follow up in the majority of the cases. Mean Preop VAS for leg 7, 8 (SD 1, 8) Postop at 1 year 3, 1 (SD 1, 4) p\0, 05. Preop ODI 64 (SD 12) Postop ODI at 1 year 42 (SD 7). The fusion rate was estimated using the Lenke classification on CT scans of the lumbar spine at 1 year and 2 years. At 1 year the fusion rate was 78, 8% and at 2 years 84, 6%. Conclusion: The minimal invasive unilateral pedicle screw fixation with transforaminal interbody fusion for the treatment of one level symptomatic degenerative disc disease is an efficient and safe method compared to the bilateral pedicle screw fixation which has the advantage of preserving the midline musculo-ligamentous structures and the contralateral facet joint. Disclosures: Author 1: none; author 2: none; author 3: none; author 4: none.
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