Journal of Korean Neurosurgical Society

  • 제45권2호
  • /
  • Pages.74-80
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  • 2009
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Comparison between Instrumented Mini-TLIF and Instrumented Circumferential Fusion in Adult Low-Grade Lytic Spondylolisthesis : Can Mini-TLIF with PPF Replace Circumferential Fusion?

  • Kim, Jin-Sung (Department of Neurosurgery, Wooridul Spine Hospital) ;
  • Kim, Dong-Hyun (Department of Neurosurgery, Leon Wiltse Memorial Hospital) ;
  • Lee, Sang-Ho (Department of Neurosurgery, Wooridul Spine Hospital)
  • 발행 : 2009.02.28
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초록

Objective : To evaluate clinical and radiological results of two different fusion techniques in adult low-grade isthmic spondylolisthesis. Methods : Between November 2003 and December 2004, 46 consecutive patients underwent instrumented mini-transforaminal lumbar interbody fusion (mini-TLIF) (group I) at Wooridul Spine Hospital, Seoul, Korea. Between February 2003 and October 2006, 32 consecutive patients underwent instrumented circumferential fusion (group II) at Leon Wiltse Memorial Hospital, Suwon, Korea. The mean follow-up periods were 29.7 and 26.1 months, respectively. Results : Mean visual analog scale (VAS) scores for back and leg pain decreased, respectively, from 6.98 and 6.33 to 2.3 and 2.2 in group I and from 7.38 and 6.00 to 1.7 and 1.0 in group II. Mean Oswestry disability index (ODI) improved from 51.85% to 14.4% in group I and from 60% to 9.1% in group II. In both groups, VAS and ODI scores significantly changed from pre- to postoperatively (p<0.001), but postoperative outcome between groups was statistically not significant. Radiologic evidence of fusion was noted in 95.7% and 100% of the patients in group I and II, respectively. In both groups, changes in disc height, segmental lordosis, degree of listhesis, and whole lumbar lordosis between the pre- and postoperative periods were significant except whole lumbar lordosis in both groups. Conclusion : Clinical and functional outcomes demonstrate no significant differences between groups in treating back and leg pain of adult patients with low-grade isthmic spondylolisthesis. However, in terms of operative data (i.e. operation time and hospital stay), instrumented mini-TLIF demonstrated better results.

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참고문헌

  1. Bagby GW : Arthrodesis by the distraction-compression method using a stainless steel implant. Orthopedics 11 : 931-934, 1988
  2. Chastain CA, Eck JC, Hodges SD, Levi P : Transforaminal lumbar interbody fusion: a retrospective study of long-term pain relief and fusion outcomes. Orthopedics 30 : 389-392, 2007
  3. Christensen FB : Lumbar spinal fusion. Outcome in relation to surgical methods, choice of implant and postoperative rehabilitation. Acta Orthop Scand Suppl 75 : 2-43, 2004 https://doi.org/10.1080/00016470410001708010
  4. Christensen FB, Hansen ES, Eiskjaer SP, H$\phi$y K, Helmig P, Neumann P, et al : Circumferential lumbar spinal fusion with Brantigan cage versus posterolateral fusion with titanium Cotrel-Dubousset instrumentation : a prospective, randomized clinical study of 146 patients. Spine 27 : 2674-2683, 2002 https://doi.org/10.1097/00007632-200212010-00006
  5. Dou Y, Hao D, Wen S, He B : Comparison of clinical outcomes between two methods of posterior lumbar interbody fusion in adult spondylolisthesis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 20 : 743-746, 2006
  6. Goldstein JA, Macenski MJ, Griffith SL, McAfee PC : Lumbar sagittal alignment after fusion with a threaded interbody cage. Spine 26 : 1137-1142, 2001 https://doi.org/10.1097/00007632-200105150-00009
  7. G$\ddot{o}$dde S, Fritsch E, Dienst M, Kohn D : Influence of cage geometry on sagittal alignment in instrumented posterior lumbar interbody fusion. Spine 28 : 1693-1699, 2003 https://doi.org/10.1097/00007632-200308010-00012
  8. Holly LT, Schwender JD, Rouben DP, Foley KT : Minimally invasive transforaminal lumbar interbody fusion : indications, technique, and complications. Neurosurg Focus 20 : E6, 2006
  9. Houten JK, Post NH, Dryer JW, Errico TJ : Clinical and radiographically/ neuroimaging documented outcome in transforaminal lumbar interbody fusion. Neurosurg Focus 20 : E8, 2006 https://doi.org/10.3171/foc.2006.20.4.5
  10. Humphreys SC, Hodges SD, Patwardhan AG, Eck JC, Murphy RB, Covington LA : Comparison of posterior and transforaminal approaches to lumbar interbody fusion. Spine 26 : 567-571, 2001 https://doi.org/10.1097/00007632-200103010-00023
  11. 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
  12. Jacobs WC, Vreeling A, De Kleuver M : Fusion for low-grade adult isthmic spondylolisthesis : a systematic review of the literature. Eur Spine J 15 : 391-402, 2006 https://doi.org/10.1007/s00586-005-1021-4
  13. Jang JS, Lee SH : Minimally invasive transforaminal lumbar interbody fusion with ipsilateral pedicle screw and contralateral facet screw fixation. J Neurosurg Spine 3 : 218-223, 2005 https://doi.org/10.3171/spi.2005.3.3.0218
  14. Kim NH, Lee JW : Anterior interbody fusion versus posterolateral fusion with transpedicular fixation for isthmic spondylolisthesis in adults. A comparison of clinical results. Spine 24 : 812-816; discussion 817, 1999 https://doi.org/10.1097/00007632-199904150-00014
  15. 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
  16. Kwon BK, Hilibrand AS, Malloy K, Savas PE, Silva MT, Albert TJ, et al : A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis. J Spinal Disord Tech (18 Suppl) : S30-S40, 2005
  17. 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 (2 Suppl) : 143-150, 2003 https://doi.org/10.3171/jns.2003.99.1.0143
  18. Labelle H, Roussouly P, Berthonnaud E, Transfeldt E, O’Brien M, Chopin D, et al : Spondylolisthesis, pelvic incidence, and spinopelvic balance : a correlation study. Spine 29 : 2049-2054, 2004 https://doi.org/10.1097/01.brs.0000138279.53439.cc
  19. Lauber S, Schulte TL, Liljenqvist U, Halm H, Hackenberg L : Clinical and radiologic 2-4-year results of transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Spine 31 : 1693-1698, 2006 https://doi.org/10.1097/01.brs.0000224530.08481.4e
  20. Laus M, Tigani D, Pignatti G, Alfonso C, Malaguti C, Monti C, et al : Posterolateral spinal fusion : a study of 123 cases with a longterm follow-up. Chir Organi Mov 79 : 69-79, 1994
  21. 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. Spine J 4 : 644-649, 2004 https://doi.org/10.1016/j.spinee.2004.04.012
  22. 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
  23. McAfee PC : Interbody fusion cages in reconstructive operations on the spine. J Bone Joint Surg Am 81 : 859-880, 1999
  24. Moller H, Hedlund R : Surgery versus conservative management in adult isthmic spondylolisthesis--a prospective randomized study : part 1. Spine 25 : 1711-1715, 2000 https://doi.org/10.1097/00007632-200007010-00016
  25. Mummaneni PV, Rodts GE Jr : The mini-open transforaminal lumbar interbody fusion. Neurosurgery 57 (4 Suppl) : 256-261; discussion 256-261, 2005
  26. Osterman K, Schlenzka D, Poussa M, Seitsalo S, Virta L : Isthmic spondylolisthesis in symptomatic and asymptomatic subjects, epidemiology, and natural history with special reference to disk abnormality and mode of treatment. Clin Orthop Relat Res 297 : 65-70, 1993
  27. Ozgur BM, Yoo K, Rodriguez G, Taylor WR : Minimally-invasive technique for transforaminal lumbar interbody fusion (TLIF). Eur Spine J 14 : 887-894, 2005 https://doi.org/10.1007/s00586-005-0941-3
  28. Roussouly P, Gollogly S, Berthonnaud E, Labelle H, Weidenbaum M : Sagittal alignment of the spine and pelvis in the presence of L5-s1 isthmic lysis and low-grade spondylolisthesis. Spine 31 : 2484-2490, 2006 https://doi.org/10.1097/01.brs.0000239155.37261.69
  29. Schwender JD, Holly LT, Rouben DP, Foley KT : Minimally invasive transforaminal lumbar interbody fusion (TLIF) : technical feasibility and initial results. J Spinal Disord Tech 18 Suppl : S1-S6, 2005 https://doi.org/10.1097/01.bsd.0000132291.50455.d0
  30. Southwick WO, Robinson RA : Surgical approaches to the vertebral bodies in the cervical and lumbar regions. J Bone Joint Surg Am 39A : 631-644, 1957
  31. Swan J, Hurwitz E, Malek F, van den Haak E, Cheng I, Alamin T, et al : Surgical treatment for unstable low-grade isthmic spondylolisthesis in adults : a prospective controlled study of posterior instrumented fusion compared with combined anterior-posterior fusion. Spine J 6 : 606-614, 2006 https://doi.org/10.1016/j.spinee.2006.02.032
  32. Tuttle J, Shakir A, Choudhri HF : Paramedian approach for transforaminal lumbar interbody fusion with unilateral pedicle screw fixation. Technical note and preliminary report on 47 cases. Neurosurg Focus 20 : E5, 2006
  33. Videbaek TS, Christensen FB, Soegaard R, Hansen ES, H$\phi$y K, Helmig P, et al : Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion : long-term results of a randomized clinical trial. Spine 31 : 2875-2880, 2006 https://doi.org/10.1097/01.brs.0000247793.99827.b7
  34. Whitecloud TS 3rd, Roesch WW, Ricciardi JE : Transforaminal interbody fusion versus anterior-posterior interbody fusion of the lumbar spine : a financial analysis. J Spinal Disord 14 : 100-103, 2001 https://doi.org/10.1097/00002517-200104000-00002
  35. Yashiro K, Homma T, Hokari Y, Katsumi Y, Okumura H, Hirano A : The Steffee variable screw placement system using different methods of bone grafting. Spine 16 : 1329-1334, 1991 https://doi.org/10.1097/00007632-199111000-00014

피인용 문헌

  1. Minimally Invasive Transforaminal Lumbar Interbody Fusion Using a Single Interbody Cage and a Tubular Retraction System : Technical Tips, and Perioperative, Radiologic and Clinical Outcomes vol.48, pp.3, 2010, https://doi.org/10.3340/jkns.2010.48.3.219
  2. Comparison of Functional Outcomes following Surgical Decompression and Posterolateral Instrumented Fusion in Single Level Low Grade Lumbar Degenerative versus Isthmic Spondylolisthesis vol.6, pp.2, 2014, https://doi.org/10.4055/cios.2014.6.2.185
  3. Fusion techniques for adult isthmic spondylolisthesis: a systematic review vol.134, pp.6, 2009, https://doi.org/10.1007/s00402-014-1985-9
  4. Transforaminal lumbar interbody fusion versus posterolateral fusion in degenerative lumbar spondylosis : A meta-analysis vol.95, pp.40, 2009, https://doi.org/10.1097/md.0000000000004995
  5. Different Fusion Approaches for Single-level Lumbar Spondylolysis Have Similar Perioperative Outcomes vol.43, pp.2, 2009, https://doi.org/10.1097/brs.0000000000002262