Endoscopic transforaminal lumbar decompression, interbody fusion and pedicle screw fixation-a report of 42 cases

被引:26
作者
Zhou Yue [1 ]
Zhang Chao [1 ]
Wang Jian [1 ]
Chu Tong-wei [1 ]
Li Chang-qing [1 ]
Zhang Zheng-feng [1 ]
Zheng Wen-jie [1 ]
机构
[1] Third Mil Med Univ, Xinqiao Hosp, Dept Orthoped, Chongqing 400037, Peoples R China
关键词
Spine; Surgical procedures; operative; Bone screws; Decompression; surgical;
D O I
10.1016/S1008-1275(08)60047-4
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective: To evaluate the surgical procedure of endoscopic transforminal discectomy, bone grafting and Dynalok pedicle screw fixation under X-Tube operation system in the treatment of lumbar disc herniation combined with segmental instability and/or pars defected spondylolithesis. Methods: From June 2004 to May 2006, 42 patients with classic features of lumbar disc herniation combined with segmental instability and/or pars defected spondylolithesis underwent endoscopic transforminal lumbar interbody fusion (TLIF). Under the guidance of fluoroscopy, a 2.8 to 3.0 cm incision with 4.5 to5.0 cm apart from the posterior middle line was made on the symptomatic side and the working portal (X-Tube) was docked unilaterally on the facet joint. A total facetectomy was then performed to expose neural foramina and nerve root. Discectomy and endplate preparation were completed through the tube. A Telamon cage was placed obliquely into the intervertebral space after interbody grafting, and then the Dynalok pedicle screw fixation system was performed. This procedure was accomplished on the lateral side when it is necessary. Results: Clinical outcomes were determined using the Oswestry Disability Index (ODI) which revealed that 62.2% of patients got excellent results, 29.2% good and 8.6% fair. The average hospital stay was 12.5 days (5-25 days). Operation time averaged 240 min (110-320 min), blood loss averaged 140ml (80-420 ml) and incision length averaged 3 cm (2.8-3.2 cm). Five patients had complications including wound infection in 1 case, incision dehiscence and focal skin necrosis in 1, progressive radicular pain of contralateral leg in 1 and residual radicular numbness after transient radicular pain in 2. Conclusions: This surgical procedure of endoscopic transforminal diskectomy, bone grafting, cage placement and pedicle screw fixation can be effectively accomplished under X-Tube operation system with predominant benefits such as small incision, less stripping of paraspinal muscles, minimal blood loss and rapid postoperative recovery.
引用
收藏
页码:225 / 231
页数:7
相关论文
共 50 条
[41]   Stability of transforaminal lumbar interbody fusion in the setting of retained facets and posterior fixation using transfacet or standard pedicle screws [J].
Chin, Kingsley R. ;
Reis, Marco T. ;
Reyes, Phillip M. ;
Newcomb, Anna G. U. ;
Neagoe, Anda ;
Gabriel, Josue P. ;
Sung, Roger D. ;
Crawford, Neil R. .
SPINE JOURNAL, 2015, 15 (05) :1077-1082
[42]   Oblique Lateral Interbody Fusion with Anterolateral Screw Fixation Is as Effective as with Posterior Percutaneous Pedicle Screw Fixation in Treating Single-Segment Mild Degenerative Lumbar Diseases [J].
Guo, Yunshan ;
Wang, Xiaodong ;
Li, Yibing ;
Jiang, Kuo ;
Chen, Bo ;
An, Jing ;
Hao, Dingjun ;
Hu, Huimin .
MEDICAL SCIENCE MONITOR, 2022, 28
[43]   Comparison of minimally invasive transforaminal lumbar interbody fusion and endoscopic lumbar interbody fusion for lumbar degenerative diseases: a retrospective observational study [J].
Chen, Hao ;
Zheng, Goudi ;
Bian, Zhenyu ;
Hou, Changju ;
Li, Maoqiang ;
Zhang, Zhen ;
Zhu, Liulong ;
Wang, Xuepeng .
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2023, 18 (01)
[44]   Is Full-Endoscopic Transforaminal Lumbar Interbody Fusion Superior to Open Transforaminal Lumbar Interbody Fusion for Single-Level Degenerative Lumbar Spondylolisthesis? A Retrospective Study [J].
Yin, Jianjian ;
Jiang, Xijia ;
Xu, Nanwei ;
Nong, Luming ;
Jiang, Yuqing .
JOURNAL OF NEUROLOGICAL SURGERY PART A-CENTRAL EUROPEAN NEUROSURGERY, 2024, 85 (01) :39-47
[45]   Unilateral versus bilateral pedicle screw fixation with posterior lumbar interbody fusion for lumbar degenerative diseases A meta-analysis [J].
Liu, Huan ;
Xu, Ying ;
Yang, Si-Dong ;
Wang, Tao ;
Wang, Hui ;
Liu, Feng-Yu ;
Ding, Wen-Yuan .
MEDICINE, 2017, 96 (21)
[46]   Full Endoscopic Lumbar Transforaminal Interbody Fusion in DDD Lumbar Degenerative Disc Disease: A Latest Technique [J].
Sharma, Manoj ;
Chhawra, Sanjay ;
Jain, Raman ;
Sharma, Sandeep .
INTERNATIONAL JOURNAL OF SPINE SURGERY, 2021, 14 :S71-S77
[47]   Comparative Outcomes of Biportal Endoscopic Decompression, Conventional Subtotal Laminectomy, and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Central Stenosis [J].
Ha Lee, Mu ;
Jang, Hyun Jun ;
Moon, Bong Ju ;
Kim, Kyung Hyun ;
Chin, Dong Kyu ;
Kim, Keun Su ;
Park, Jeong-Yoon .
NEUROSPINE, 2024, 21 (04) :1178-1189
[48]   Full-Endoscopic Lumbar Interbody Fusion Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion with a Tubular Retractor System: A Retrospective Controlled Study [J].
Wang, Jin-Chang ;
Cao, Zheng ;
Li, Zhen-Zhou ;
Zhao, Hong-Liang ;
Hou, Shu-Xun .
WORLD NEUROSURGERY, 2022, 165 :E457-E468
[49]   Unilateral Versus Bilateral Pedicle Screw Fixation in Transforaminal Lumbar Interbody Fusion A Monocentric Study of 215 Patients With a Minimum of 4-Year Follow-up [J].
Liu, Fubing ;
Feng, Zhenzhou ;
Zhou, Xiaogang ;
Liang, Yun ;
Jiang, Chun ;
Li, Xilei ;
Li, Zheng ;
Jiang, Xiaoxing ;
Dong, Jian .
CLINICAL SPINE SURGERY, 2017, 30 (06) :E776-E783
[50]   Robotic endoscopic transforaminal lumbar interbody fusion: A single institution case series [J].
Saway, B. F. ;
Cunningham, C. ;
Pereira, M. ;
Sowlat, M. ;
Elawady, S. S. ;
Porto, G. ;
Barley, J. ;
Nordmann, Nathan ;
Frankel, B. .
WORLD NEUROSURGERY-X, 2024, 23