Literature DB >> 22200020

Comparative Study of Posterior Lumbar Interbody Fusion via Unilateral and Bilateral Approaches in Patients with Unilateral Leg Symptoms.

Ji-Hoon Seong1, Jong-Won Lee, Ki-Young Kwon, Jong-Joo Rhee, Jin-Woo Hur, Hyun-Koo Lee.   

Abstract

OBJECTIVE: We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms.
METHODS: We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated.
RESULTS: In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group.
CONCLUSION: Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

Entities:  

Keywords:  Iatrogenic root injury; Posterior lumbar interbody fusion; Unilateral approach; Unilateral leg symptoms

Year:  2011        PMID: 22200020      PMCID: PMC3243841          DOI: 10.3340/jkns.2011.50.4.363

Source DB:  PubMed          Journal:  J Korean Neurosurg Soc        ISSN: 1225-8245


  36 in total

Review 1.  Posterior lumbar interbody fusion (PLIF): past, present, and future.

Authors:  P M Lin
Journal:  Clin Neurosurg       Date:  2000

2.  Analysis of operative complications in a series of 471 anterior lumbar interbody fusion procedures.

Authors:  Rick C Sasso; Natalie M Best; Praveen V Mummaneni; Thomas M Reilly; Sajjad M Hussain
Journal:  Spine (Phila Pa 1976)       Date:  2005-03-15       Impact factor: 3.468

3.  In vitro stabilizing effect of a transforaminal compared with two posterior lumbar interbody fusion cages.

Authors:  Annette Kettler; Werner Schmoelz; Erich Kast; Maria Gottwald; Lutz Claes; Hans-Joachim Wilke
Journal:  Spine (Phila Pa 1976)       Date:  2005-11-15       Impact factor: 3.468

4.  Cage migration in spondylolisthesis treated with posterior lumbar interbody fusion using BAK cages.

Authors:  Liang Chen; Huilin Yang; Tiansi Tang
Journal:  Spine (Phila Pa 1976)       Date:  2005-10-01       Impact factor: 3.468

5.  The effect of interspinous ligament integrity on adjacent segment instability after lumbar instrumentation and laminectomy--an experimental study in porcine model.

Authors:  Lih-Huei Chen; Po-Liang Lai; Ching-Lung Tai; Chi-Chien Niu; Tsai-Sheng Fu; Wen-Jer Chen
Journal:  Biomed Mater Eng       Date:  2006       Impact factor: 1.300

6.  Complications of posterior lumbar interbody fusion when using a titanium threaded cage device.

Authors:  W J Elias; N E Simmons; G J Kaptain; J B Chadduck; R Whitehill
Journal:  J Neurosurg       Date:  2000-07       Impact factor: 5.115

7.  Trans-foraminal versus posterior lumbar interbody fusion: comparison of surgical morbidity.

Authors:  Vivek A Mehta; Matthew J McGirt; Giannina L Garcés Ambrossi; Scott L Parker; Daniel M Sciubba; Ali Bydon; Jean-Paul Wolinsky; Ziya L Gokaslan; Timothy F Witham
Journal:  Neurol Res       Date:  2010-06-11       Impact factor: 2.448

8.  Posterior lumbar interbody fusion using one diagonal fusion cage with transpedicular screw/rod fixation.

Authors:  Jie Zhao; Tiesheng Hou; Xinwei Wang; Shengzhong Ma
Journal:  Eur Spine J       Date:  2003-01-11       Impact factor: 3.134

9.  Biomechanical analysis of unilateral fixation with interbody cages.

Authors:  Hsiang-Ho Chen; Hung-Hsueh Cheung; Wei-Kai Wang; Allen Li; Kung-Chia Li
Journal:  Spine (Phila Pa 1976)       Date:  2005-02-15       Impact factor: 3.468

10.  Biomechanical properties of threaded inserts for lumbar interbody spinal fusion.

Authors:  A F Tencer; D Hampton; S Eddy
Journal:  Spine (Phila Pa 1976)       Date:  1995-11-15       Impact factor: 3.468

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  2 in total

1.  Clinical and Radiological Results of Microsurgical Posterior Lumbar Interbody Fusion and Decompression without Posterior Instrumentation for Lateral Recess Stenosis.

Authors:  Mehmet Demirayak; Lokman Şişman; Faik Türkmen; Duran Efe; Oğuzhan Pekince; Recep Gani Göncü; Cem Sever
Journal:  Asian Spine J       Date:  2015-09-22

2.  Introducing a new risk factor for lumbar disc herniation in females : vertical angle of the sacral curvature.

Authors:  Ayhan Kanat; Ugur Yazar; Hizir Kazdal; Osman Fikret Sonmez
Journal:  J Korean Neurosurg Soc       Date:  2012-11-30
  2 in total

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