Department of Neuroscience, Neurosurgery Section, University of Turin, Turin, Italy.
Biomed Res Int. 2018 Feb 18;2018:7424568. doi: 10.1155/2018/7424568. eCollection 2018.
A prospective comparative study between classical posterior interbody fusion with peduncular screws and the new technique with divergent cortical screws was conducted.
Only patients with monosegmental degenerative disease were recruited into this study. We analyzed a cohort of 40 patients treated from January 2015 to March 2016 divided into 2 groups (20 patients went to traditional open surgery and 20 patients under mini-invasive strategy). Primary endpoints of this study are fusion rate and muscular damage; secondary endpoints analyzed were three different clinical scores (ODI, VAS, and EQ) and the morbidity rate of both techniques.
There was no significant difference in fusion rate between the two techniques. In addition, a significant difference in muscular damage was found according to the MRI evaluation. Clinical outcomes, based on pain intensity, Oswestry Disability Index status, and Euroquality-5D score, were found to be also statistically different, even one year after surgery. This study also demonstrated a correlation between patients' muscular damage and their clinical outcome.
Cortical bone trajectory screws would provide similar outcomes compared to pedicle screws in posterior lumbar interbody fusion at one year after surgery, and this technique represents a reasonable alternative to pedicle screws.
本研究进行了一项经典的后路经椎间孔椎体间融合术（TLIF）伴椎弓根螺钉与新型经皮质骨轨迹螺钉技术的前瞻性对比研究。
仅纳入单节段退变性疾病的患者。我们分析了一组 40 例患者，这些患者于 2015 年 1 月至 2016 年 3 月期间接受了治疗，分为两组（20 例患者接受传统开放手术，20 例患者接受微创策略）。本研究的主要终点是融合率和肌肉损伤；次要终点分析了三种不同的临床评分（ODI、VAS 和 EQ）以及两种技术的发病率。
两种技术的融合率无显著差异。此外，根据 MRI 评估，发现肌肉损伤存在显著差异。基于疼痛强度、Oswestry 残疾指数状况和 Euroquality-5D 评分的临床结果也存在统计学差异，甚至在手术后一年也是如此。本研究还表明，患者的肌肉损伤与他们的临床结果之间存在相关性。
皮质骨轨迹螺钉在术后一年与 TLIF 伴椎弓根螺钉提供相似的结果，该技术是椎弓根螺钉的合理替代方法。
