Minimally invasive unilateral pedicle screws and a translaminar facet screw fixation and interbody fusion for treatment
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RESEARCH ARTICLE
Open Access
Minimally invasive unilateral pedicle screws and a translaminar facet screw fixation and interbody fusion for treatment of singlesegment lower lumbar vertebral disease: surgical technique and preliminary clinical results Peng Huang, Yiguo Wang, Jiao Xu, Bo Xiao, Jianheng Liu, Luyang Che and Keya Mao*
Abstract Background: Conventional open transforaminal lumbar interbody fusion (TLIF) using unilateral pedicle screws and a translaminar facet screw has been performed for many years with good results. The outcomes of minimally invasive TLIF (MIS TLIF) are similar to the good outcomes of open TLIF, with the additional benefits of reducing iatrogenic injury, shortening hospital stays, and reducing the recovery duration. Instead of using small cuts on both sides, we performed MIS TLIF through a single cut using unilateral pedicle screws and a translaminar facet screw. The operative feasibility, efficacy safety, and benefits of single-level MIS TLIF of such techniques require further clarification. Methods: A total of 60 patients with various single-segment lower lumbar vertebral diseases were treated in our department from January 2010 to March 2013. All the patients were initially performed single-level MIS TLIF using a hybrid construction of unilateral pedicle screws and a translaminar facet screw. Patient demographics and operative data were collected. The clinical outcomes were assessed before surgery and 3, 6, 12, and 24 months after surgery using the visual analog scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Radiologic assessment of the lumbar spine with static and dynamic plain radiographs was performed 3, 6, 12, and 24 months after surgery. The fusion rates were assessed by an independent radiologist 2 years after surgery according to the Bridwell interbody fusion grading system. (Continued on next page)
* Correspondence: [email protected] Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Huang et al. Journal of Orthopaedic Surgery and Research (2017) 12:117
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Results: No patients experienced significant postoperative complications. Excepting two cases, 58 cases were followed up for 24–38 months, averaged 29.9 ± 4.1 months. The patients’ average age was 46.6 ± 11.5 years, operative time 109. 7 ± 17.8 min, intraoperative blood loss 67.3 ± 29.7 ml, length of incision 29.0 ± 3.2 mm, f
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