Murat Ulutaş1, Can Yaldız2, Mehmet Seçer3, Mehmet Ali İkidağ4, Mehmet Ali Cüce4, Onur Yaman5, Sedat Dalbayrak6. 1. Department of Neurosurgery, Konukoglu Hospital, Sanko University, Gaziantep, Turkey. 2. Department of Neurosurgery, Sakarya University Training and Research Hospital, Sakarya, Turkey. Electronic address: drcanyaldiz@gmail.com. 3. Department of Neurosurgery, Deva Hospital, Gaziantep, Turkey. 4. Department of Radiology, Konukoglu Hospital, Sanko University, Gaziantep, Turkey. 5. Department of Neurosurgery, Koç University, İstanbul, Turkey. 6. Department of Neurosurgery, Neuro Spine Academy, Istanbul, Turkey.
Abstract
AIM: Minimally invasive approaches to posterior lumbar surgery are available today that can enhance patient comfort by greatly reducing tissue damage and offer better clinical results. However, such methods have not yet gained widespread popularity despite their significant advantages. This study compares the Wiltse method and the classical method of lumbar surgery based a cohort, clinical study of 57 patients. The patients all had degenerative lumbar spinal stenosis and/or spondylolisthesis and had developed multifidus muscular atrophy. MATERIALS AND METHODS: We enrolled 57 patients admitted to our clinic between April 2012 and September 2013 with a diagnosis of degenerative lumbar spinal stenosis and/or spondylolisthesis. These were treated with the classic posterior approach (n=26) or the Wiltse method (n=31). FINDINGS: In the classical method group, the ratio of female to male patients was 20/6 and the mean age was 58.19±10.17 years. A comparison of preoperative and postoperative multifidus muscle cross-sectional measurements (average of right and left) revealed a 36.09% atrophy level in the classical method group and a 26.34% atrophy level in the Wiltse group (p<0.01). However, atrophy development was 18.82% higher in the classical method group (p<0.05) relative to the Wiltse group. CONCLUSION: The Wiltse method is less invasive and causes less tissue damage. It reduces the change of hemorrhage and multifidus muscles and offers a shorter duration of hospitalization with less pain.
AIM: Minimally invasive approaches to posterior lumbar surgery are available today that can enhance patient comfort by greatly reducing tissue damage and offer better clinical results. However, such methods have not yet gained widespread popularity despite their significant advantages. This study compares the Wiltse method and the classical method of lumbar surgery based a cohort, clinical study of 57 patients. The patients all had degenerative lumbar spinal stenosis and/or spondylolisthesis and had developed multifidus muscular atrophy. MATERIALS AND METHODS: We enrolled 57 patients admitted to our clinic between April 2012 and September 2013 with a diagnosis of degenerative lumbar spinal stenosis and/or spondylolisthesis. These were treated with the classic posterior approach (n=26) or the Wiltse method (n=31). FINDINGS: In the classical method group, the ratio of female to male patients was 20/6 and the mean age was 58.19±10.17 years. A comparison of preoperative and postoperative multifidus muscle cross-sectional measurements (average of right and left) revealed a 36.09% atrophy level in the classical method group and a 26.34% atrophy level in the Wiltse group (p<0.01). However, atrophy development was 18.82% higher in the classical method group (p<0.05) relative to the Wiltse group. CONCLUSION: The Wiltse method is less invasive and causes less tissue damage. It reduces the change of hemorrhage and multifidus muscles and offers a shorter duration of hospitalization with less pain.
Authors: Martín Gagliardi; Alfredo Guiroy; Federico Fernández Molina; Francisco Fasano; Alejandro Morales Ciancio; Juan José Mezzadri; Pablo Jalón Journal: Surg Neurol Int Date: 2017-10-24