eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
6/2018
vol. 14
 
Share:
Share:
more
 
 
abstract:
Clinical research

Comparison of unilateral pedicle screw fixation and interbody fusion with PEEK cage vs. standalone expandable fusion cage for the treatment of unilateral lumbar disc herniation

Jinlei Zhang, Aixing Pan, Li Zhou, Jingyi Yu, Xiao Zhang

Arch Med Sci 2018; 14, 6: 1432–1438
Online publish date: 2018/04/06
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
This study was conducted to compare the clinical effects of unilateral pedicle screw fixation and interbody fusion with PEEK cage (UPSFC) and standalone expandable fusion cage (SAEFC) on unilateral lumbar disc herniation.

Material and methods
From September 2011 to July 2014, a respective investigation was performed on 130 lumbar disc herniation patients treated with SAEFC or UPSFC. The hospital stay, operating time, blood loss, Japanese orthopaedic association scores (JOA), and visual analogue score (VAS) in the two groups were compared using Student’s t-test.

Results
The average of follow-up time was 25.6 ±6.4 and 25.2 ±5.8 months, respectively. No significant difference in the postoperative hospitalizsation, intraoperative blood loss, operative time, and postoperative fusion rate was detected between the two groups. VAS score in the UPSFC group was significantly lower than in the SAEFC group at 6 and 12 months after operation (p = 0.014, p = 0.004). X-ray images indicated that the subsidence rate was 8.1% (5/62) in the SAEFC group, while no subsidence was detected in UPSFC group 12 month after operation.

Conclusions
Both SAEFC and UPSFC are effective techniques. UPSFC may be a better choice for patients with lumbar disc herniation and unilateral limb symptoms of nerve root in view of the advantages of better low back pain relief and low subsidence rate.

keywords:

lumbar disc herniation, unilateral pedicle screw fixation and interbody fusion with PEEK cage, standalone expandable fusion cage, Peek cage

references:
Suk KS, Lee HM, Moon SH, Kim NH. Recurrent lumbar disc herniation: results of operative management. Spine (Phila Pa 1976) 2001; 26: 672-6.
Kim KT, Park SW, Kim YB. Disc height and segmental motion as risk factors for recurrent lumbar disc herniation. Spine (Phila Pa 1976) 2009; 34: 2674-8.
Hoogland T, van den Brekel-Dijkstra K, Schubert M, Miklitz B. Endoscopic transforaminal discectomy for recurrent lumbar disc herniation: a prospective, cohort evaluation of 262 consecutive cases. Spine (Phila Pa 1976) 2008; 33: 973-8.
Groff MW, Dailey AT, Ghogawala Z, et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 12: pedicle screw fixation as an adjunct to posterolateral fusion.
J Neurosurg Spine 2014; 21: 75-8.
Noshchenko A, Hoffecker L, Lindley EM, et al. Perioperative and long-term clinical outcomes for bone morphogenetic protein versus iliac crest bone graft for lumbar fusion in degenerative disk disease: systematic review with meta-analysis. J Spinal Disord Tech 2014; 27: 117-35.
Choi JY, Sung KH. Subsidence after anterior lumbar interbody fusion using paired stand-alone rectangular cages. Eur Spine J 2006; 15: 16-22.
Fogel GR, Toohey JS, Neidre A, Brantigan JW. Is one cage enough in posterior lumbar interbody fusion: a comparison of unilateral single cage interbody fusion to bilateral cages. J Spinal Disord Tech 2007; 20: 60-5.
Li X, Lv C, Yan T. Unilateral versus bilateral pedicle screw fixation for degenerative lumbar diseases: a meta-analysis of 10 randomized controlled trials. Med Sci Monit 2015; 21: 782-90.
Xiao SW, Jiang H, Yang LJ, Xiao ZM. Comparison of unilateral versus bilateral pedicle screw fixation with cage fusion in degenerative lumbar diseases: a meta-analysis. Eur Spine J 2015; 24: 764-74.
Rosenberg WS, Mummaneni PV. Transforaminal lumbar interbody fusion: technique, complications, and early results. Neurosurgery 2001; 48: 569-74.
Duncan JW, Bailey RA. An analysis of fusion cage migration in unilateral and bilateral fixation with transforaminal lumbar interbody fusion. Eur Spine J 2013; 22: 439-45.
Lee JC, Kim Y, Soh JW, Shin BJ. Risk factors of adjacent segment disease requiring surgery after lumbar spinal fusion: comparison of posterior lumbar interbody fusion and posterolateral fusion. Spine (Phila Pa 1976) 2014; 39: E339-45.
Park P, Garton HJ, Gala VC, Hoff JT, McGillicuddy JE. Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine (Phila Pa 1976) 2004; 29: 1938-44.
Phan K, Leung V, Scherman DB, Tan AR, Rao PJ, Mobbs RJ. Bilateral versus unilateral instrumentation in spinal surgery: systematic review and trial sequential analysis of prospective studies. J Clin Neurosci 2016; 30: 15-23.
Molinari RW, Saleh A, Molinari R Jr, Hermsmeyer J, Dettori JR. Unilateral versus bilateral instrumentation in spinal surgery: a systematic review. Global Spine J 2015; 5: 185-94.
Emstad E, Del Monaco DC, Fielding LC, Block JE. The VariLift((R)) Interbody Fusion System: expandable, standalone interbody fusion. Med Devices (Auckl) 2015; 8: 219-30.
Shah RR, Mohammed S, Saifuddin A, Taylor BA. Comparison of plain radiographs with CT scan to evaluate interbody fusion following the use of titanium interbody cages and transpedicular instrumentation. Eur Spine J 2003; 12: 378-85.
Neely WF, Fichtel F, Del Monaco DC, Block JE. Treatment of symptomatic lumbar disc degeneration with the VariLift-L Interbody Fusion System: retrospective review of 470 cases. Int J Spine Surg 2016; 10: 15.
Xin Z, Li W. Unilateral versus bilateral pedicle screw fixation in short-segment lumbar spinal fusion: a meta-
analysis of randomised controlled trials. Int Orthop 2016; 40: 355-64.
Kim KH, Park JY, Chin DK. Fusion criteria for posterior lumbar interbody fusion with intervertebral cages: the significance of traction spur. J Korean Neurosurg Soc 2009; 46: 328-32.
Park JH, Roh SW. Long-term clinical and radiological outcomes following stand-alone PLIF surgery using expandable cylindrical threaded cages in patients with degenerative lumbar spine disease. Acta Neurochir (Wien) 2011; 153: 1409-16.
Kim Y. Prediction of mechanical behaviors at interfaces between bone and two interbody cages of lumbar spine segments. Spine (Phila Pa 1976) 2001; 26: 1437-42.
Fuji T, Oda T, Kato Y, Fujita S, Tanaka M. Posterior lumbar interbody fusion using titanium cylindrical threaded cages: is optimal interbody fusion possible without other instrumentation? J Orthop Sci 2003; 8: 142-7.
FEATURED PRODUCTS
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe