Facet Joint Fixation and Anterior, Direct Lateral, and Transforaminal Lumbar Interbody Fusions for Treatment of Degenerative Lumbar Disc Diseases: Retrospective Cohort Study of a New Minimally Invasive Technique

Authors

• Evgenii Belykh, Scientific Center of Reconstructive and Restorative Surgery, Siberian Branch of the Russian Academy of Medical Sciences, Irkutsk, Russia; Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
• Andrey A. Kalinin, Scientific Center of Reconstructive and Restorative Surgery, Siberian Branch of the Russian Academy of Medical Sciences, Irkutsk, Russia; Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia; Irkutsk Railway Clinical Hospital, Irkutsk, Russia.
• Nikolay L. Martirosyan, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
• Talgat Kerimbayev, Department of Spinal Surgery and Pathology of Peripheral Nervous System, JSC "National Center of Neurosurgery", Astana, Kazakhstan.
• Nicholas Theodore, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• Mark C. Preul, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• Vadim A. Byvaltsev, Scientific Center of Reconstructive and Restorative Surgery, Siberian Branch of the Russian Academy of Medical Sciences, Irkutsk, Russia; Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia; Irkutsk Railway Clinical Hospital, Irkutsk, Russia. Electronic address: Neuropub@dignityhealth.org.

Document Type

Article

Abstract

BACKGROUND: Anterior, direct lateral, and transforaminal lumbar interbody fusions (ALIF, DLIF, and TLIF) are usually combined with posterior fixation to treat degenerative spinal diseases. Outcomes of ALIF, TLIF, or DLIF combined with a new wedge-shaped interfacet cage plate have not been reported. We assessed early clinical outcomes of patients treated with interbody fusion and facet fixation using a titanium wedge-shaped cage plate. METHODS: This retrospective observational cohort study included patients (n = 80) who underwent 1-level interbody fusion and facet joint fixation via ALIF (n = 24) or DLIF (n = 26) with bilateral facet fixation or TLIF with ipsilateral pedicle screws and contralateral facet fixation (n = 30). Duration of surgery, estimated blood loss, pain (visual analog scale), Oswestry Disability Index (ODI) scores, and Macnab score were assessed up to 12 months after surgery. RESULTS: All patients had a significant decrease in pain scores (P < 0.01) and an increase in ODI scores (P < 0.01), without significant differences between treatment groups. Most surgical outcomes were excellent or good (n = 75, 93.8%) with 5 patients (6.2%) having satisfactory outcomes. Within 2 months, all patients returned to their previous work (66, 82.5%) or lighter work (14, 17.5%). Two patients had fusion failure requiring reoperation. CONCLUSIONS: Facet fixation with the wedge-shaped cage plate was associated with minimal soft tissue damage and a low level of postoperative pain. ALIF, DLIF, and TLIF combined with this technique showed good early postoperative clinical and radiologic outcomes. Further studies are needed to assess long-term results and compare them with other fusion methods.

Medical Subject Headings

Adult; Cohort Studies; Female; Humans; Internal Fixators; Intervertebral Disc Degeneration (diagnostic imaging, surgery); Intervertebral Disc Displacement (diagnostic imaging, surgery); Lumbar Vertebrae (diagnostic imaging, surgery); Male; Middle Aged; Minimally Invasive Surgical Procedures (instrumentation, methods); Prospective Studies; Retrospective Studies; Spinal Fusion (instrumentation, methods); Treatment Outcome; Zygapophyseal Joint (diagnostic imaging, surgery)

Publication Date

6-1-2018

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

114

First Page

e959

Last Page

e968

PubMed ID

29588241

Digital Object Identifier (DOI)

10.1016/j.wneu.2018.03.121

Recommended Citation

Belykh, Evgenii; Kalinin, Andrey A.; Martirosyan, Nikolay L.; Kerimbayev, Talgat; Theodore, Nicholas; Preul, Mark C.; and Byvaltsev, Vadim A., "Facet Joint Fixation and Anterior, Direct Lateral, and Transforaminal Lumbar Interbody Fusions for Treatment of Degenerative Lumbar Disc Diseases: Retrospective Cohort Study of a New Minimally Invasive Technique" (2018). Neurosurgery. 1683.
https://scholar.barrowneuro.org/neurosurgery/1683