Elmekaty Mohamed, ElMehy Emad, Försth Peter, MacDowall Anna, Elemi Ahmed El, Hosni Mohamed, Robinson Yohan
Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden - Orthopedic and Traumatology Department, Tanta University, Tanta, Egypt.
Orthopedic and Traumatology Department, Tanta University, Tanta, Egypt.
SICOT J. 2018;4:24. doi: 10.1051/sicotj/2018019. Epub 2018 Jun 29.
Transforaminal lumbar interbody fusion (TLIF) is used to reconstruct disc height and reduce degenerative deformity in spinal fusion. Patients with osteoporosis are at high risk of TLIF cage subsidence; possibly due to the relatively small footprint compared to anterior interbody devices. Recently, modular TLIF cage with an integral rail and slot system was developed to reduce cage subsidence and allow early rehabilitation.
To study the safety of a modular TLIF device in patients with degenerative disc disorders (DDD) with regard to surgical complications, non-union, and subsidence.
Patients with DDD treated with a modular TLIF cage (Polyetheretherketone (PEEK), VTI interfuse S) were analysed retrospectively with one-year follow-up. Lumbar sagittal parameters were collected preoperatively, postoperatively and at one year follow-up. Cage subsidence, fusion rate, screw loosening and proportion of endplate coverage were assessed in computed tomography scan.
20 patients (age 66 ± 10 years, 65% female, BMI 28 ± 5 kg/m) with a total of 37 fusion levels were included. 15 patients had degenerative spondylosis and 5 patients had degenerative scoliosis. The cages covered >60% of the vertebral body diameters. Lumbar lordosis angle and segmental disc angle increased from 45.2 ± 14.5 and 7.3 ± 3.6 to 52.7 ± 9.1 and 10.5 ± 3.5 (p = 0.029 and 0.0002) postoperatively for each parameter respectively without loss of correction at one year follow up. One case of deep postoperative infection occurred (5%). No cage subsidence occurred. No non-union or screw loosening occurred.
The modular TLIF cage was safe with regard to subsidence and union-rate. It restored and maintained lumbar lordosis angle, segmental disc angle and disc height, which can be attributed to the large footprint of this modular cage.
经椎间孔腰椎椎体间融合术（TLIF）用于重建椎间盘高度并减少脊柱融合术中的退行性畸形。骨质疏松患者进行TLIF椎间融合器下沉的风险较高；这可能是由于与前路椎间装置相比，其接触面积相对较小。最近，一种带有一体式轨道和插槽系统的模块化TLIF椎间融合器被开发出来，以减少椎间融合器下沉并允许早期康复。
研究模块化TLIF装置在患有退行性椎间盘疾病（DDD）的患者中的安全性，包括手术并发症、不融合和下沉情况。
对接受模块化TLIF椎间融合器（聚醚醚酮（PEEK），VTI interfuse S）治疗的DDD患者进行回顾性分析，随访一年。术前、术后及随访一年时收集腰椎矢状面参数。通过计算机断层扫描评估椎间融合器下沉、融合率、螺钉松动及终板覆盖比例。
纳入20例患者（年龄66±10岁，65%为女性，体重指数28±5kg/m），共37个融合节段。15例患者患有退行性脊柱病，5例患者患有退行性脊柱侧弯。椎间融合器覆盖椎体直径的>60%。术后每个参数的腰椎前凸角和节段椎间盘角分别从45.2±14.5和7.3±3.6增加到52.7±9.1和10.5±3.5（p分别为0.029和0.0002），随访一年时无矫正丢失。发生1例术后深部感染（5%）。未发生椎间融合器下沉。未发生不融合或螺钉松动。
模块化TLIF椎间融合器在下沉和融合率方面是安全的。它恢复并维持了腰椎前凸角、节段椎间盘角和椎间盘高度，这可归因于该模块化椎间融合器的较大接触面积。
