Sonmez Erkin, Coven Ilker, Sahinturk Fikret, Yilmaz Cem, Caner Hakan
Baskent University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey.
Turk Neurosurg. 2013;23(3):372-8. doi: 10.5137/1019-5149.JTN.7122-12.1.
To compare the clinical and radiological outcomes of recurrent disk disease in patients who underwent unilateral and bilateral percutaneous pedicle screw instrumentation with Mis-TLIF.
10 patients treated with unilateral percutaneous instrumentation plus Mis-TLIF formed Group 1 while the other 10 patients treated with bilateral percutaneous instrumentation plus Mis-TLIF formed Group 2. Clinical outcomes were graded using the visual analog scale (VAS) and the Oswestry disability index (ODI) scores. Peroperative and 2-year follow-up scores were obtained. Postoperative imaging techniques were used for the assessment of fusion, subsidence and spinal alignment.
According to preoperative and postoperative VAS/ODI scores, statistically significant differences were noted in the unilaterally and bilaterally instrumented group. However, a statistically significant difference was not observed between the unilateral and bilateral groups. Radiological evidence of successful arthrodesis was noted in 8 of 10 patients (80%) in the unilaterally instrumented group and in 9 of 10 patients (90%) in the bilaterally instrumented group at the 2 years follow-up. No metal failure, cage migration, vertebral fracture, subsidence or adjacent level disease was experienced.
Mis-TLIF with unilateral percutaneous pedicle screw instrumentation is an excellent option in the treatment of selected recurrent disk disease patients.
比较接受单侧和双侧经皮椎弓根螺钉内固定联合微创经椎间孔腰椎椎体间融合术(Mis-TLIF)治疗的复发性椎间盘疾病患者的临床和影像学结果。
10例接受单侧经皮内固定联合Mis-TLIF治疗的患者组成第1组,另外10例接受双侧经皮内固定联合Mis-TLIF治疗的患者组成第2组。使用视觉模拟量表(VAS)和奥斯维斯特残疾指数(ODI)评分对临床结果进行分级。获取手术中和2年随访时的评分。采用术后影像学技术评估融合、下沉和脊柱对线情况。
根据术前和术后的VAS/ODI评分,单侧和双侧内固定组之间存在统计学上的显著差异。然而,单侧和双侧组之间未观察到统计学上的显著差异。在2年随访时,单侧内固定组10例患者中有8例(80%)出现成功椎间融合的影像学证据,双侧内固定组10例患者中有9例(90%)出现成功椎间融合的影像学证据。未发生金属失败、椎间融合器移位、椎体骨折、下沉或邻近节段疾病。
单侧经皮椎弓根螺钉内固定联合Mis-TLIF是治疗部分复发性椎间盘疾病患者的极佳选择。