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Comparison of Outcomes of Anterior, Posterior, and Transforaminal Lumbar Interbody Fusion Surgery at a Single Lumbar Level with Degenerative Spinal Disease.

Authors
 Nam Lee  ;  Keung Nyun Kim  ;  Seong Yi  ;  Yoon Ha  ;  Dong Ah Shin  ;  Do Heum Yoon  ;  Keun Su Kim 
Citation
 World Neurosurgery, Vol.101 : 216-226, 2017 
Journal Title
 World Neurosurgery 
ISSN
 1878-8750 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae/diagnostic imaging* ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Neurodegenerative Diseases/diagnostic imaging* ; Neurodegenerative Diseases/epidemiology ; Neurodegenerative Diseases/surgery* ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Retrospective Studies ; Spinal Fusion/adverse effects ; Spinal Fusion/methods* ; Treatment Outcome ; Young Adult
Keywords
Anterior lumbar interbody fusion ; Computed tomography (CT) ; Fusion rate ; Posterior lumbar interbody fusion ; Subsidence \ ; Transforaminal interbody fusion
Abstract
OBJECTIVE: The fusion rate in spinal surgery may vary in relation to the technique, and it remains unknown which surgical technique provides the best fusion rate and surgical outcome. We aimed to compare radiologic and surgical results between 3 surgical techniques used for lumbar interbody fusion. METHODS: Participants included 77 patients diagnosed with degenerative spinal stenosis including spondylolytic spondylolisthesis. Patients were divided into 3 groups according to surgical technique: anterior lumbar interbody fusion (ALIF, n = 26), transforaminal lumbar interbody fusion (TLIF, n = 21), and posterior lumbar interbody fusion (PLIF, n = 30). Various radiologic parameters were measured, including fusion rates. RESULTS: Significant changes after surgery were observed in the ALIF group for the percentage of vertebral body slippage, anterior disk height, posterior disk height, and segmental range of movement (ROM). The fusion rate on computed tomography (CT) scan at the final follow-up was 69.2% in the ALIF group, 72.7% in the TLIF group, and 64.3% in the PLIF group. The cage subsidence rate 2 years after surgery was 15.4% in the ALIF group, 38.1% in the TLIF group, and 10% in the PLIF group. CONCLUSIONS: ALIF was associated with better restoration of segmental lordosis. The fusion rate on CT scan and with segmental ROM did not differ between the 3 groups. TLIF was associated with a better postoperative visual analog scale. PLIF showed the lowest cage subsidence rate. Therefore, it is difficult to know which surgical technique is better among the 3 groups because each surgical method has its own advantages.
Full Text
https://www.sciencedirect.com/science/article/pii/S1878875017301407
DOI
10.1016/j.wneu.2017.01.114
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
김근수(Kim, Keun Su) ORCID logo https://orcid.org/0000-0002-3384-5638
김긍년(Kim, Keung Nyun)
신동아(Shin, Dong Ah) ORCID logo https://orcid.org/0000-0002-5225-4083
윤도흠(Yoon, Do Heum) ORCID logo https://orcid.org/0000-0003-1452-5724
이성(Yi, Seong)
하윤(Ha, Yoon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160632
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