To present two minimally invasive surgical techniques using cortical bone trajectory screws with posterior lumbar interbody fusion (CBT-PLIF) and traditional pedicle screws and a domino system with transforaminal lumbar interbody fusion (TPS-Domino-TLIF) for adjacent segment disease (ASD) after lumbar fusion surgery, and compare the postoperative radiographic and clinical outcomes between the two techniques for ASD.
Of the 36 patients included in this study, 16 patients received CBT-PLIF and the other 20 patients received TPS-Domino-TLIF. Patient demographics, surgical data, complications, radiologic and clinical outcomes were evaluated and compared between the two groups.
The surgical duration of TPS-Domino-TLIF was significantly shorter than that of CBT-PLIF (p < 0.001). There was less estimated blood loss (EBL) and a lower frequency of intra-operative fluoroscopy in TPS-Domino-TLIF as compared with CBT-PLIF (p < 0.001). The lumbar lordotic angle was improved both at immediate post-operation (p = 0.006) and the last follow-up (p = 0.007) in TPS-Domino-TLIF group as compared with CBT-PLIF group. The mean inter-vertebral height in TPS-Domino-TLIF group was significantly larger than that in CBT-PLIF group at immediate post-operation (p = 0.007) and the last follow-up (p = 0.005). The clinical outcomes in terms of the mean VAS-back, VAS-leg and ODI were improved significantly postoperatively in both groups.
As a more minimally invasive surgical technique for ASD, TPS-Domino-TLIF could be considered a viable alternative to the midline fusion technique using CBT.
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Posted 17 Aug, 2020
Posted 17 Aug, 2020
To present two minimally invasive surgical techniques using cortical bone trajectory screws with posterior lumbar interbody fusion (CBT-PLIF) and traditional pedicle screws and a domino system with transforaminal lumbar interbody fusion (TPS-Domino-TLIF) for adjacent segment disease (ASD) after lumbar fusion surgery, and compare the postoperative radiographic and clinical outcomes between the two techniques for ASD.
Of the 36 patients included in this study, 16 patients received CBT-PLIF and the other 20 patients received TPS-Domino-TLIF. Patient demographics, surgical data, complications, radiologic and clinical outcomes were evaluated and compared between the two groups.
The surgical duration of TPS-Domino-TLIF was significantly shorter than that of CBT-PLIF (p < 0.001). There was less estimated blood loss (EBL) and a lower frequency of intra-operative fluoroscopy in TPS-Domino-TLIF as compared with CBT-PLIF (p < 0.001). The lumbar lordotic angle was improved both at immediate post-operation (p = 0.006) and the last follow-up (p = 0.007) in TPS-Domino-TLIF group as compared with CBT-PLIF group. The mean inter-vertebral height in TPS-Domino-TLIF group was significantly larger than that in CBT-PLIF group at immediate post-operation (p = 0.007) and the last follow-up (p = 0.005). The clinical outcomes in terms of the mean VAS-back, VAS-leg and ODI were improved significantly postoperatively in both groups.
As a more minimally invasive surgical technique for ASD, TPS-Domino-TLIF could be considered a viable alternative to the midline fusion technique using CBT.
Figure 1
Figure 2
Figure 3
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