(Işık Üniversitesi, Sağlık Hizmetleri Meslek Yüksekokulu, Ameliyathane Hizmetleri Bölümü, İstanbul, Türkiye)
Mehmet TEZER
(Nişantaşı Ortopedi Grubu, İstanbul, Türkiye)
(Nişantaşı Ortopedi Grubu, İstanbul, Türkiye)
Yıl: 2019Cilt: 30Sayı: 1ISSN: 2147-5903Sayfa Aralığı: 47 - 53İngilizce

165 6
Purpose: Transforaminal lumbar interbody fusion (TLIF) is a surgical method that allows stable fusion of the anterior spinal column and restoration of disc height and lumbar lordosis. The aim of this study was to evaluate the clinical and radiological data of the patients who underwent lumbar discectomy, posterior instrumentation and laminectomy or TLIF surgery and who applied to our clinic with the complaint of discogenic back or leg pain and investigate the effectiveness of procedure.Material and Methods: Between the years 2012-2016, patients who underwent TLIF procedure were analyzed retrospectively. Inclusion criteria; patients undergone surgery due to any disc pathology from the lumbar region, complaints that did not respond to a minimum of 6 weeks of conservative treatment, patients undergoing revision surgery with two levels or more TLIF procedure with posterior instrumentation and a follow-up period longer than 2 years. Radiological and clinical data of 13 patients who met these criteria were examined for the study.Results: The study group consisted of 11 women and 2 men. The mean follow-up period was 39.3 months (range 26-58). The mean age was 62.2 (range 56-71). 7 patients had previously undergone lumbar discectomy, 4 patients had posterior instrumentation and laminectomy, 2 patients had posterior instrumentation and TLIF procedure. The dominant complaint was back pain in all patients. There were also complaints of varying rates of radicular pain and combinations of neurological deficit. Indications for revision surgery; lumbar degenerative disc disease, recurrent lumbar disc herniation, lumbar spinal canal stenosis, segmental instability and spondylolisthesis with two levels and higher. A total of 77, mean 5.9 (1.4) pedicle screws were placed. A total of 32, average 2.4 (0.5) levels of TLIF were applied. In 8 (61.5%) patients, pedicle screws was augmented with cement. The mean operative time was 378.8 min, and the mean amount of blood loss was 684.6 ml. The mean amount of autotransfusion and allogeneic blood transfusion was 569.2 ml. Mean duration of hospital stay was 4.6 days. One patient had dural tear during the operation. In one patient, the wound drainage that started in the postoperative 10. day was healed with wound debridement and antibiotic treatment. None of the patients had proximal or distal adjacent segment fracture, implant failure, nonunion or loss of correction during the follow-up. Complete neurological recovery was observed in all patients except the patient who was admitted with a 6-month history of foot drop.Conclusions: TLIF is a safe and effective procedure for the treatment of spinal pathologies in revision surgery. Elimination of spinal stenosis and instability, decompression of nerve roots, restoration of intervertebral disc heights, restoring lumbar lordosis, neutralization of global spinal balance and pain relief are possible.
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DergiAraştırma MakalesiErişime Açık
  • Blume HG. Unilateral posterior lumbar interbody fusion: simplified dowel technique. Clin Orthop Relat Res 1985; 193: 75–84.
  • Branch CL. The case for posterior lumbar interbody fusion. Clin Neurosurg 1996; 43: 252–267.
  • Brodano GB1, Martikos K, Lolli F, Gasbarrini A, Cioni A, Bandiera S,Silvestre MD,Boriani S,Greggi T.Transforaminal lumbar interbody fusion in degenerative disk disease and spondylolisthesis grade i: minimally invasive versus open surgery. J Spinal Disord Tech 2015; 28(10): E559-564.
  • Chen Z, Zhao J, Liu A, Yuan J, Li Z. Surgical treatment of recurrent lumbar disc herniation by transforaminal lumbar interbody fusion. Int Orthop 2009; 33(1): 197-201.
  • Di Paola CP, Molinari RW. Posterior lumbar interbody fusion. J Am Acad Orthop Surg 2008; 16: 130–139.
  • Erdem MN, Karaca S, Sarı S, Yumrukcal F, Tanli R, Aydogan M. Application of cement on strategic vertebrae in the treatment of the osteoporotic spine. Spine J 2017; 17(3): 328- 337.
  • German JW, Foley KT. Minimal access surgical techniques in the management of the painful lumbar motion segment. Spine 2005; 30: S52–59.
  • Harms J, Rolinger H. A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author’s transl). Z Orthop Ihre Grenzgeb 1982; 120: 343–347.
  • Harms JG, Jeszenszky D. Die posteriore, lumbale, interkorporelle fusion in unilateraler transforaminaler technik. Oper Orthop Traumatol 1998; 10: 90–102.
  • Hsieh PC, Koski TR, O’Shaughnessy BA, Sugrue P, Salehi S, Ondra S, Liu JC. Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion: Implications for the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance. J Neurosurg Spine 2007; 7: 379-386.
  • Park Y, Ha YW. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine 2007; 32: 537–543.
  • Peng CW, Yue WM, Poh SY, Yeo W, Tan SB. Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine 2009; 34: 1385–1389.
  • Ploumis A, Wu C, Fischer G, Mehbod AA, Wu W, Faundez A, Mehbod AA, Wu W, Faundez A, Transfeldt EE. Biomechanical comparison of anterior lumbar interbody fusion and transforaminal lumbar interbody fusion. J Spinal Disord Tech 2008; 21: 120-125. Potter BK, Freedman BA, Verwiebe EG, Hall JM, Polly DW Jr, Kuklo TR. Transforaminal lumbar interbody fusion: clinical and radiographic results and complications in 100 consecutive patients. J Spinal Disord Tech 2005;18: 337–346.
  • Scheufler KM, Dohmen H, Vougioukas VI. Percutaneous transforaminal lumbar interbody fusion for the treatment of degenerative lumbar instability. Neurosurgery 2007; 60(5): 203-12.
  • Schwender JD, Holly LT, Rouben DP, Foley KT. Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results. J Spinal Disord Tech 2005; 18: 1-6.
  • Shunwu F, Xing Z, Fengdong Z, Xiangqian F. Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases. Spine 2010; 35: 1615–1620.
  • Starkweather AR, Witek-Janusek L, Nockels RP, Peterson J, Mathews HL. The multiple benefits of minimally invasi ve spinal surgery: results comparing transforaminal lumbar interbody fusion and posterior lumbar fusion. J Neurosci Nurs 2008; 40: 32-39.
  • Suk SI, Lee CK, Kim WJ, Lee JH, Cho KJ, Kim HG. Adding posterior lumbar interbody fusion to pedicle screw fixation and posterolateral fusion after decompression in spondylolytic spondylolisthesis. Spine 1997; 22(2): 210-219.
  • Taneichi H, Suda K, Kajino T, Matsumura A, Moridaira H, Kaneda K. Unilateral transforaminal lumbar interbody fusion and bilateral anterior-column fixation with two Brantigan I/F cages per level: clinical outcomes during a minimum 2-year follow-up period. J Neurosurg Spine 2006; 4: 198–205.
  • Villavicencio AT, Burneikiene S, Roeca CM, Nelson EL, Mason A. Minimally invasive versus open transforaminal lumbar interbody fusion. Surg Neurol Int 2010; 1: 12.
  • Voor MJ, Mehta S, Wang M, Zhang YM, Mahan J, Johnson JRl. Biomechanical evaluation of posterior and anterior lumbar interbody fusion techniques. J Spinal Disord 1998; 11: 328–334.
  • Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J. Minimally invasive or open transforaminal lumbar interbody fusion as revision surgery for patients previously treated by open discectomy and decompression of the lumbar spine. Eur Spine J 2011; 20(4): 623-628.
  • White AA III, Panjabi MM. Clinical biomechanics of the spine, 2nd ed. Lippincott, Philadelphia 1990.
  • Yucesoy K, Yuksel KZ, Baek S, Sonntag VK, Crawford NR. Biomechanics of unilateral compared with bilateral lumbar pedicle screw fixation for stabilization of unilateral vertebral disease. J Neurosurg Spine 2008; 8: 44–51.
  • Xiao Y, Li F, Chen Q. Transforaminal lumbar interbody fusion with one cage and excised local bone. Arch Orthop Trauma Surg 2010; 130: 591–597.

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