gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Minimally invasive transpedicular stabilisation via a lateral dorsal paraspinal approach with transforaminal lumbar interbody fusion

Minimal-invasive transpedikuläre Stabilisation über einen lateralen dorsalen paraspinalen Zugang mit transforaminaler lumbaler interkorporeller Fusion

Meeting Abstract

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  • corresponding author U. Vieweg - Zentrum für Wirbelsäulenstabilisationen, Neurochirurgische Klinik, Leopoldina Krankenhaus, Schweinfurt

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSA.04.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc110.shtml

Published: May 8, 2006

© 2006 Vieweg.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Retrospective analysis of the minimally invasive transpedicular stabilisation via a lateral dorsal paraspinal approach with microsurgical transforaminal lumbar interbody fusion (TLIF).

Methods: Twenty-eight patients with degenerative disorders of the lumbar spine, mean age 67 (52 – 82) years were operated using a posterior polyaxial fixation system (S4 Spinal System, B. Braun – Aesculap) and a banana-shaped transforaminal lumbar interbody fusion device. The lateral dorsal paraspinal approach was performed using the CASPAR MLD retractor system (B. Braun – Aesculap). Three patients were operated on two levels and 25 patients on one level. We analysed the average operation time, the blood loss, complications, post – operative pain reduction according to the VAS score and the time of mobilisation after the operation. The screw positioning and reduction of a spondylolisthesis were determined from plain radiographs and CT-scans.

Results: The average operation time was 85 minutes and the average blood loss was 160ml. There was only one nerve root irritation with dyaesthesia. Only one day after operation 26 patients were immediately mobilised. The average pain rate according to the VAS score was praeoperatively 7 (range: 6 - 8) and seven days after operation 2 (range:0 - 3). A good screw positioning and complete reduction of a spondylolisthesis could be proven postoperatively by image control.

Conclusions: The lateral Wiltse approach with a posterior polyaxial fixation device in combination with the microsurgical TLIF technique represents a minimally invasive procedure. The first clinical results are convincing. To perform this technique it is necessary to have experience with the use of a microscope and the TLIF-technique.