Are There Segmental Differences of Lumbar Spondylodesis? - Comparison of the Segments L IV/V and L V/S I in Patients with Transforaminal Lumbar Intercorporal Fusion (TLIF)

Linhardt, O. and Grifka, J. and Benditz, A. (2015) Are There Segmental Differences of Lumbar Spondylodesis? - Comparison of the Segments L IV/V and L V/S I in Patients with Transforaminal Lumbar Intercorporal Fusion (TLIF). ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE, 153 (5). pp. 546-551. ISSN 1864-6697, 1864-6743

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Abstract

Background: The aim of this study was to report surgical results with open TLIF (transforaminal lumbar intervertebral fusion) of segment L V/S I, in comparison with TLIF of segment L IV/V. Patients and Methods: 60 patients with degenerative spine disease were operated with TLIF spondylodesis and followed up in a clinical and radiological study. 30 patients were operated in segment L IV/V (group 1) and another 30 in segment L V/S I (group 2). These patients were followed up 2 weeks and 12 months after surgery, by means of a clinical examination and questionnaires on pain (visual analogue scale) and quality of life (Oswestry score). Results: The rate of intra-and postoperative complications was 5% in all 60 patients; the fusion ratewas 100%. In all patients, a 70% improvement in back pain, leg pain and quality of life was achieved after 12 months. For leg pain and quality of life, a significantly better result was seen in group 1 than in group 2 two weeks after the operation. This may be explained by reversible dysaesthesias in 3 patients in group 2. In 2 patients in group 2, it was necessary to convert from TLIF to ALIF (anterior lumbar interbody fusion). Directly after the operation, the mean intervertebral height was 8.2mm in group 1 and 7.3 mm in group 2, in comparison with 7.7 mm and 6.8 mm after one year, respectively. Conclusion: In patients with contraction osteochondrosis in segment L V/S I, spondylodesis in segment L V/S I is - for anatomical reasons - more likely to be linked to reversible nerve irritations than with segment L IV/V. In some cases, conversion from TLIF on ALIF is necessary. In patients with degenerative spine disease, TLIF in segments L IV/V and L V/S I is absolutely accepted as a safe and up-to-date procedure.

Item Type: Article
Uncontrolled Keywords: INTERBODY FUSION; PEDICLE SCREW; SPINE; PLIF; SPONDYLOLISTHESIS; SURGERY; CAGES; spondylodesis; TLIF; osteochondrosis
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Orthopädie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 06 Jun 2019 10:40
Last Modified: 06 Jun 2019 10:40
URI: https://pred.uni-regensburg.de/id/eprint/4742

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