Posterolateral versus circumferential instrumented fusion for monosegmental lumbar degenerative disc disease using an expandable cage

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• 作者：Panagiotis Korovessis (1)
  Thomas Repantis (1)
  Andreas Baikousis (2)
  Panagiotis Iliopoulos (3)
  
• 关键词：PLIF ; B ; twin ; Degenerative lumbar disease ; Circumferential fusion
• 刊名：European Journal of Orthopaedic Surgery & Traumatology
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：22
• 期：8
• 页码：639-645
• 参考文献：1. DeWald RL, Faut MM, Taddonio RF et al (1981) Severe lumbosacral spondylolisthesis in adolescents and children. Reduction and staged circumferential fusion. J Bone Joint Surg Am 63:619-26
  2. Helenius I, Lamberg T, Osterman K et al (2006) Posterolateral, anterior, or circumferential fusion in situ for high-grade spondylolisthesis in young patients: a long-term evaluation using the Scoliosis Research Society Questionnaire. Spine 31:190-96 CrossRef
  3. Madan SS, Harley JM, Boeree NR (2003) Circumferential and posterolateral fusion for lumbar disc disease. Clin Orthop Relat Res 409:114-23 CrossRef
  4. Rosenberg WS, Mummaneni PV (2001) Transforaminal lumbar interbody fusion: technique, complications, and early results. Neurosurgery 48:569-75 CrossRef
  5. Tay BB, Berven S (2002) Indications, techniques, and complications of lumbar interbody fusion. Semin Neurol 22:221-30 CrossRef
  6. Tiusanen H, Schlenzka D, Seitsalo S et al (1996) Results of a trial of anterior or circumferential lumbar fusion in the treatment of severe isthmic spondylolisthesis in young patients. J Pediatr Orthop B 5:190-94 CrossRef
  7. Gertzbein SD, Betz R, Clements D et al (1996) Semirigid instrumentation in the management of lumbar spinal conditions combined with circumferential fusion: a multicenter study. Spine 21:1918-925 CrossRef
  8. Madan S, Boeree NR (2002) Outcome of posterior lumbar interbody fusion versus posterolateral fusion for spondylolytic spondylolisthesis. Spine 27:1536-542 CrossRef
  9. Suk S, Lee C, Kim WJ et al (1997) Adding posterior lumbar interbody fusion to pedicle screw fixation and posterolateral fusion after decompression in spondylolytic spondylolisthesis. Spine 22:210-20 CrossRef
  10. Soegaard R, Bunger CE, Christiansen T et al (2007) Circumferential fusion is dominant over posterolateral fusion in a long-term perspective: cost-utility evaluation of a randomized controlled trial in severe, chronic low back pain. Spine 32:2405-414 CrossRef
  11. Videbaek TS, Christensen FB, Soegaard R et al (2006) Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial. Spine 31:2875-880 CrossRef
  12. France JC, Yaszemski MJ, Lauerman WC et al (1999) A randomized prospective study of posterolateral lumbar fusion: outcomes with and without pedicle screw instrumentation. Spine 24:553-60 CrossRef
  13. Leufveń C, Nordwall A (1999) Management of chronic disabling low back pain with 360 degrees fusion. Results from pain provocation test and concurrent posterior lumbar interbody fusion, posterolateral fusion, and pedicle screw instrumentation in patients with chronic disabling low back pain. Spine 24:2042-045 CrossRef
  14. Fritzell P, Hagg O, Wessberg P et al (2002) Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group. Spine 27:1131-141 CrossRef
  15. Kim KT, Lee SH, Lee YH et al (2006) Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine. Spine 31:1351-357 Discussion 1358 CrossRef
  16. Swan J, Hurwitz E, Malek F et al (2006) 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 6:606-14 CrossRef
  17. Elias WJ, Simmons NE, Kaptain GJ, Chadduck JB, Whitehill R (2000) Complications of posterior lumbar interbody fusion when using a titanium threaded cage device. J Neurosurg 93(1 suppl):45-2
  18. Ray CD (1997) Threaded titanium cages for lumbar interbody fusion. Spine 22:667-80 CrossRef
  19. Wetzel FT, La Rocca H (1991) The failed lumbar interbody fusion. Spine 16:839-45 CrossRef
  20. Chen HH, Cheung HH, Wang WK, Li A, Li KC (2005) Biomechanical analysis of unilateral fixation with interbody cages. Spine 30:E92–E96 CrossRef
  21. Blume HG, Rojas CH (1981) Unilateral lumbar interbody fusion (posterior approach) utilizing dowel grafts: experience in over 200 patients. J Neurol Orthop Surg 2:171-77
  22. Zhao J, Haim Y, Ordway RO et al (2000) Posterior interbody fusion using posterolateral placement of a single cylindrical threaded cage. Spine 25:425-30 CrossRef
  23. Zhao J, Wang X, Hou T et al (2002) One versus two BAK fusion cages in posterior lumbar interbody fusion to L4–L5 degenerative spondylolisthesis: a randomized, controlled prospective study in 25 patients with minimum two year follow-up. Spine 27:2753-757 CrossRef
  24. Folman Y, Lee SH, Silvera JR et al (2003) Posterior lumbar interbody fusion for degenerative disc disease using a minimally invasive B-Twin expandable spinal spacer: a muticenter study. J Spinal Disord Tech 16(5):455-60 CrossRef
  25. Xiao L, Xiong D, Zhang Q et al (2010) Percutaneous posterior-lateral lumbar interbody fusion for degenerative disc disease using a B-Twin expandable spinal spacer. Eur Spine J 19:325-30 CrossRef
  26. Christensen FB, Hansen ES, Eiskjaer SP, H?y K, Helmig P, Neumann P, Niedermann B, Bünger CE (2002) Circumferential lumbar spinal fusion with Brantigan cage versus posterolateral fusion with titanium Cotrel-Dubousset instrumentation: A prospective, randomized clinical study of 146 patients. Spine 27:2674-683 CrossRef
  27. Siambanes D, Mather S (1988) Comparison of plain radiographs and CT scans in instrumented posterior interbody fusion. Orthopedics 21:165-67
  28. Fraser RD (1995) Interbody, posterior, and combined lumbar fusions. Spine 20:S167–S177 CrossRef
  29. MacNab I, Dall D (1971) The blood supply of the lumbar spine and its application to the technique of intertransverse lumbar fusion. J Bone Joint Surg Br 53:628-38
  30. Korovessis P, Papazisis Z, Koureas G et al (2004) Rigid, semirigid versus dynamic instrumentation for degenerative lumbar spinal stenosis: a correlative radiological and clinical analysis of short-term results. Spine 29:735-42 CrossRef
  31. Rompe JD, Eysel P, Hopf C (1995) Clinical efficacy of pedicle instrumentation and posterolateral fusion in the symptomatic degenerative lumbar spine. Eur Spine J 4:231-37 CrossRef
  32. Boos N, Marcheri D, Zuber K et al (1993) Treatment of severe spondylolisthesis by reduction and pedicular fixation. A 4--year follow-up study. Spine 18:1655-661 CrossRef
  33. Hinkley BS, Jaremko ME (1997) Effects of 360-degree lumbar fusion in a workers-compensation population. Spine 22:312-22 CrossRef
  34. Videbaek TS, Christensen FB, Soegaard R, Hansen ES, H?y K, Helmig P et al (2006) Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial. Spine 25:2875-880 CrossRef
  35. Freeman BI, Licina P, Mehdian SH (2000) Posterior lumbar interbody fusion combined with instrumented postero-lateral fusion: 5-year result in 60 patients. Eur Spine J 9:42-6 CrossRef
  36. Kroppenstedt S, Gulde M, Sch?nmayr R (2008) Radiological comparison of instrumented posterior lumbar interbody fusion with one or two closed-box plasmapore coated titanium cages: follow-up study over more than seven years. Spine 33:2083-088 CrossRef
  37. Molinari RW, Sloboda J, Johnston FL (2003) Are 2 cages needed with instrumented PLIF? A comparison of 1 versus 2 interbody cages in a military population. Am J Orthop 32:337-43
  38. Fogel GR, Toohey JS, Neidre A, Brantigan JW (2007) Is one cage enough in posteriorlumbar interbody fusion: A comparison of unilateral single cage interbody fusion to bilateral cages. J Spinal Disord Tech 20:60-5 CrossRef
  39. Chiang MF, Zhong ZC, Chen CS et al (2006) Biomechanical comparison of instrumented posterior lumbar interbody fusion with one or two cages by finite element analysis. Spine 31:E682–E689 CrossRef
  40. Wang ST, Goel VK, Fu CY, Kubo S, Choi W, Liu CL, Chen TH (2005) Posterior instrumentation reduces differences in spine stability as a result of different cage orientations: an in vitro study. Spine 30:62-7 CrossRef
  41. Barnes B, Rodts GE Jr, Haid RW Jr, Subach BR, McLaughlin MR (2002) Allograft implants for posterior lumbar interbody fusion: results comparing cylindrical dowels and impacted wedges. Neurosurgery 51:1191-198 CrossRef
  42. Okuda S, Miyauchi A, Oda T, Haku T, Yamamoto T, Iwasaki M (2006) Surgical complications of posterior lumbar interbody fusion with total facetectomy in 251 patients. J Neurosurg Spine 4:304-09 CrossRef
  43. Fritzell P, Haegg O, Nordwall A et al (2003) Complications in lumbar fusion surgery for chronic low back pain: comparison of three surgical techniques used in a prospective randomized study. A report from the Swedish Lumbar Spine Study Group. Eur Spine J 12:178-89
  44. Xiuxin H, Zhu Yue, Cui C et al (2009) A meta-analysis of circumferential fusion versus instrumented posterolateral fusion in the lumbar spine. Spine 34:E618–E625 CrossRef
  
• 作者单位：Panagiotis Korovessis (1)
  Thomas Repantis (1)
  Andreas Baikousis (2)
  Panagiotis Iliopoulos (3)
  
  1. Orthopaedic Department, General Hospital ‘Agios Andreas- 1 Tsertidou str, 26224, Patras, Greece
  2. Orthopaedic Department, General Hospital of Messolonghi, Messolonghi, Greece
  3. Radiology Department, General Hospital ‘Agios Andreas-Patras, Patras, Greece
  
• ISSN：1432-1068

文摘

Background Theoretically, 360° instrumented fusion has been considered to offer better radiological correction than PLF. Despite numerous publications, this correlation is still weak with several controversies in the relative literature. Purpose This prospective randomized study was designed to compare the radiological segmental results, complications and outcome of 360° instrumented fusion with the use of a single diagonal expandable PLIF device versus posterolateral pedicle screw fixation in monosegmental lumbar DDD and to show that the use of an novel expandable cage is associated with low PLIF-related complication rate compared to conventional cages reported previously. Study design Prospective randomized controlled clinical and radiological study. Patient sample Adults who suffered from monosegmental DDD were eligible for enrolment in this trial. We randomly assigned 150 patients to receive either 360° instrumented fusion (group A) with expandable cage or PLF (group B). Outcome measures Differences between the two groups regarding clinical parameters and radiographic sagittal measurements after 36?months of follow-up. Methods The record included global [T12-S1 lordosis, sagittal global spinal balance (SB) (C7-mid-femoral axis)] and segmental [segmental disc wedging (SDW), anterior (ADHr) and posterior (PDHr) disc height ratio] radiological measurements at the instrumented segment. Additionally, clinical outcome was evaluated with VAS, SF-36 (Physical function and Bodily Pain) and ODI questionnaires. Fusion was evaluated with the use of Christiansen method. Results In 73 and 72 participants of group A and B, respectively, who completed follow-up to 36?months, there were no differences with respect to the rate of improvement in SF-36, ODI and VAS scores. However, in the spines of group A, there was a significant increase in anterior disc height ratio (P?=?0.0057), posterior disc height (P?=?0.016) and segmental disc wedging (P?=?0.00021) without subsequent loss of correction. Fusion rate was radiologically shown in 94.5% and 87% spines of group A and B, respectively (P?>?0.2). Four and 9 spines in group A and B, respectively, showed non-union at the final observation. Conclusions Our findings suggest that 360° fusion offers better sagittal radiological restoration associated with circumferential fusion. However, this difference seemed not to have any medium-term clinical impact. The use of expandable cage was associated with low PLIF-related complications compared to conventional cages.