Artikel
Microsurgical transforaminal lumbar interbody fusion (TLIF) with transpedicular stabilisation – a less invasive technique
Mikrochirurgische transforaminale lumbale intercorporelle Fusion (TLIF) mit transpedikulärer Stabilisation – eine wenig invasive Technik
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Autoren
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U. Vieweg
- Zentrum für Wirbelsäulenstabilisationen, Klinik für Neurochirurgie, Leopoldina Krankenhaus, Schweinfurt
| Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: Prospective analysis of microsurgical transforaminal lumbar interbody fusion (TLIF) with transpedicular stabilisation for degenerative disorders of the lumbar spine.
Methods: Within 16 months,150 consecutive patients with degenerative disorders of the lumbar spine (spondylolishesis Meyerding I-II° n=105 , failed back surgery n=35, kyphoscoliosis n=10 ) average age: 67 (52-88) years, were operated using an internal fixator (S4 Spinal System, B.Braun-Aesculap) and a banana-shaped TLIF- device (Travios, Synthes). The operative time, the blood loss and the complications were analysed. Improvements (preoperative to last follow-up) in average, Visual Analogue Pain Scale (VAS) and Oswestry Disability Index (ODI) were documented.
Results: Operative time averaged 125 minutes. Estimated blood loss per segment 300 ml. Surgical complication rate 8% (instrumentation failures: n=2; wound infection n=2, seroma n=3, haematoma n=1, neurological detoriation n=3, instability n=1). Other complications (urinary tract infaction, pneumonia etc.) 10%. Mean follow-up 7 (3-16) months, VAS: 8,2 to 3,7; ODI: 65 to 38. At last follow-up, all patients had no instablity in the fused segments, but three an instability in the adjacent segment.
Conclusions: Based on the short operation time, the less blood loss and the relatively good clinical results in relation to the patient population, the microsurgical TLIF with a transpedicular stabilisation is a less invasive technique.
