Journal of Korean Neurosurgical Society

  • 제40권3호
  • /
  • Pages.175-179
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  • 2006
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지

Anterior Lumbar Interbody Fusion with Pedicle Screw Fixation for Elderly Isthmic Spondylolisthesis

  • Lee, Dong-Yeob (Departments of Neurosurgery, Gimpo Airport Wooridul Spine Hospital) ;
  • Lee, Sang-Ho (Departments of Neurosurgery, Gimpo Airport Wooridul Spine Hospital) ;
  • Maeng, Dae-Hyeon (Departments of Thoracic and Cardiovascular Surgery, Gimpo Airport Wooridul Spine Hospital) ;
  • Jang, Jee-Soo (Departments of Neurosurgery, Gimpo Airport Wooridul Spine Hospital)
  • 발행 : 2006.09.30
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초록

Objective : The surgical outcome of anterior lumbar interbody fusion[ALlF] with pedicle screw fixation for elderly isthmic spondylolisthesis was analyzed. Methods : Consecutive nineteen elderly patients [aged 65 years or more] with isthmic spondylolisthesis [Grade I or II] who underwent single level ALIF with pedicle screw fixation in 2002 were analyzed. Using clinical chart and mailed questionnaires, preoperative and postoperative Visual Analogue Scale[VAS] of back and leg pain and postopertive Macnab criteria were evaluated. Results : The mean age at the time of operation was 68.4 years [range 65 to 78 years]. Twelve patients underwent ALIF with percutaneous pedicle screw fixation. Seven patients underwent ALIF followed by posterior decompression and pedicle screw fixation. The postoperative complication rate was 10.5% [wound dehiscence in 1 patient and incisional hernia in 1 patient]. There was no postoperative major morbidity or mortality. At a mean follow-up duration of 30.7 months [range 25 to 35 months], 93.3% [14/15] of the patients showed excellent or good outcomes in terms of Macnab criteria. The mean VAS scores of back pain and leg pain significantly decreased after surgery. Conclusion : ALIF with pedicle screw fixation yielded favorable results for elderly isthmic spondylolisthesis in selected cases.

키워드

참고문헌

  1. Carreon LY, Puno RM, Dimar JR 2nd, Glassman SD, Johnson JR : Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am 85 : 2089-2092, 2003 https://doi.org/10.2106/00004623-200311000-00004
  2. Cheng CL, Fang D, Lee PC, Leong JC : Anterior spinal fusion for spondylolysis and isthmic spondylolisthesis. Long term results in adults. J Bone Joint Surg Br 71 : 264-267, 1989 https://doi.org/10.2106/00004623-198971020-00014
  3. Christensen FB, Karlsmose B, Hansen ES, Bunger CE : Radiological and functional outcome after anterior lumbar interbody spinal fusion. Eur Spine J 5 : 293-298, 1996 https://doi.org/10.1007/BF00304343
  4. Deyo RA, Cherkin DC, Loeser JD, Bigos SJ, Ciol MA : Morbidity and mortality in association with operation on the lumbar spine. The influence of age, diagnosis, and procedure. J Bone Joint Surg Am 74 : 536-543, 1992 https://doi.org/10.2106/00004623-199274040-00009
  5. Holte DC, O'Brien JP, Renton P : Anterior lumbar fusion using a hybrid interbody graft. A preliminary radiographic report. Eur Spine J 3 : 32-38, 1994 https://doi.org/10.1007/BF02428314
  6. Ishihara H, Osada R, Kanamori M, Kawaguchi Y, Ohmori K, Kimura T, et al : Minimum 10-year follow-up study of anterior lumbar interbody fusion for isthmic spondylolisthesis. J Spinal Disord 14 : 91-99, 2001 https://doi.org/10.1097/00002517-200104000-00001
  7. Jang JS, Lee SH : Clinical analysis of percutaneous facet screw fixation after anterior lumbar interbody fusion. J Neurosurg Spine 3 : 40-46, 2005 https://doi.org/10.3171/spi.2005.3.1.0040
  8. Jang JS, Lee SH, Lim SR : Guide device for percutaneous placement of translaminar facet screws after anterior lumbar interbody fusion. Technical note. J Neurosurg 98 : 100-103, 2003
  9. Kim SM, Lim TJ, Paterno J, Park J, Kim DH : A biomechanical comparison of supplementary posterior translaminar facet and transfacetopedicular screw fixation after anterior lumbar interbody fusion. J Neurosurg Spine 1 : 101-107, 2004 https://doi.org/10.1227/00006123-197709000-00002
  10. Kulkarni SS, Lowery GL, Ross RE, Ravi Sankar K, Lykomitros V : Arterial complications following anterior lumbar interbody fusion : report of eight cases. Eur Spine J 12 : 48-54, 2003
  11. Kwon BK, Albert TJ : Adult low-grade acquired spondylolytic spondylolisthesis. Evaluation and management. Spine 30 : S35-S41, 2005
  12. Kwon BK, Berta S, Daffner SD, Vaccaro AR, Hilibrand AS, Grauer JN, et al : Radiographic analysis of transforaminal lumbar interbody fusion for the treatment of adult isthmic spondylolisthesis. J Spinal Disord Tech 16 : 469-476, 2003 https://doi.org/10.1097/00024720-200310000-00006
  13. La Rosa G, Conti A, Cacciola F, Cardali S, La Torre D, Gambadauro NM, et al : Pedicle screw fixation for isthmic spondylolisthesis : does posterior lumbar interbody fusion improve outcome over posterolateral fusion? J Neurosurg 99 : 143-150, 2003 https://doi.org/10.3171/jns.2003.99.1.0143
  14. Lee DY, Lee SH, Maeng DH, Jang JS : Isthmic Spondylolisthesis Associated with Foraminal Disc Herniation Treated by Anterior Lumbar Interbody Fusion. J Korean Neurosurg Soc 38 : 320-322, 2005
  15. Lee SH, Choi WG, Lim SR, Kang HY, Shin SW : Minimally invasive anterior lumbar interbody fusion followed by percutaneous pedicle screw fixation for isthmic spondylolisthesis. cee SH, Choi WG, Lim SR, Kang HY, Shin SW : Minimally invasive anterior lumbar interbody fusion followed by percutaneous pedicle screw fixation for isthmic spondylolisthesis. Spine J 4 : 644-649, 2004 https://doi.org/10.1016/j.spinee.2004.04.012
  16. Loguidice VA, Johnson RG, Guyer RD, Stith WJ, Ohnmeiss DD, Hochschuler SH, et al : Anterior lumbar interbody fusion. Spine 13 : 366-369, 1988 https://doi.org/10.1097/00007632-198803000-00027
  17. Macnab I : Negative disc exploration. An analysis of the causes of nerveroot involvement in sixty-eight patients. J Bone Joint Surg Am 53 : 891-903, 1971 https://doi.org/10.2106/00004623-197153050-00004
  18. Madan S, Boeree NR : Outcome of posterior lumbar interbody fusion versus posterolateral fusion for spondylolytic spondylolisthesis. Spine 27 : 1536-1542, 2002 https://doi.org/10.1097/00007632-200207150-00011
  19. Oxland TR, Hoffer Z, Nydegger T, Rathonyi GC, Nolte LP : A comparative biomechanical investigation of anterior lumbar interbody cages : central and bilateral approaches. J Bone Joint Surg Am 82 : 383-393, 2000 https://doi.org/10.1302/0301-620X.82B3.9887
  20. Phillips FM, Cunningham B, Carandang G, Ghanayem AJ, Voronov L, Havey RM, et al : Effect of supplemental translaminar facet screw fixation on the stability of stand-alone anterior lumbar interbody fusion cages under physiologic compressive preloads. Spine 29 : 1731-1736, 2004 https://doi.org/10.1097/01.BRS.0000134570.08901.30
  21. Rathonyi GC, Oxland TR, Gerich U, Grassmann S, Nolte LP : The role of supplemental translaminar screws in anterior lumbar interbody fixation : a biomechanical study. Eur Spine J 7 : 400-407, 1998 https://doi.org/10.1007/s005860050097
  22. Scaduto AA, Gamradt SC, Yu WD, Huang J, Delamarter RB, Wang JC : Perioperative complications of threaded cylindrical lumbar fusion devices : anterior versus posterior approach. J Spinal Disord Tech 16 : 502-507, 2003 https://doi.org/10.1097/00024720-200312000-00003
  23. Shim CS, Lee SH, Jung B, Sivasabaapathi P, Park SH, Shin SW : Fluoroscopically assisted percutaneous translaminar facet screw fixation following anterior lumbar interbody fusion : technical report. Spine 30 : 838-843, 2005 https://doi.org/10.1097/01.brs.0000157473.17313.6f
  24. Spruit M, Pavlov PW, Leitao J, De Kleuver M, Anderson PG, Den Boer F : Posterior reduction and anterior lumbar interbody fusion in symptomatic low-grade adult isthmic spondylolisthesis : short-term radiological and functional outcome. Eur Spine J 11 : 428-433, 2002 https://doi.org/10.1007/s00586-002-0400-3
  25. Suk KS, Jeon CH, Park MS, Moon SH, Kim NH, Lee HM : Comparison between posterolateral fusion with pedicle screw fixation and anterior interbody fusion with pedicle screw fixation in adult spondylolytic spondylolisthesis. Yonsei Med J 42 : 316-323, 2001 https://doi.org/10.3349/ymj.2001.42.3.316
  26. Suk SI, Lee CK, Kim WJ, Lee JH, Cho KJ, Kim HG : Adding posterior lumbar interbody fusion to pedicle screw fixation and posterolateral fusion after decompression in spondylolytic spondylolisthesis. Spine 22 : 210-219, 1997 https://doi.org/10.1097/00007632-199701150-00016
  27. van Rens TJ, van Horn JR : Long-term results in lumbosacral interbody fusion for spondylolisthesis. Acta Orthop Scand 53 : 383-392, 1982 28. Vitaz TW, Raque GH, Shields CB, Glassman SD : Surgical treatment of lumbar spinal stenosis in patients older than 75 years of age. J Neurosurg 91 : 181-185, 1999
  28. Vitaz TW, Raque GH, Shields CB, Glassman SD: Surgical tteatment of lumbar spinal stenosis in patients older than 75 years of age. J Neurosurg 91: 181-185, 1999
  29. Volkman T, Horton WC, Hutton WC : Transfacet screws with lumbar interbody reconstruction : biomechanical study of motion segment stiffness. J Spinal Disord 9 : 425-432, 1996
  30. Wenger M, Sapio N, Markwalder TM : Long-term outcome in 132 consecutive patients after posterior internal fixation and fusion for grade I and II isthmic spondylolisthesis. J Neurosurg Spine 2 : 289-297, 2005 https://doi.org/10.3171/spi.2005.2.3.0289