Clinical and Radiological Outcomes of Modified Mini-Open and Open Transforaminal Lumbar Interbody Fusion: A Comparative Study

STUDY DESIGN: Retrospective cohort study. PURPOSE: To compare the clinical and radiological outcomes of modified mini-open transforaminal lumbar interbody fusion (modMOTLIF) and open TLIF (OTLIF). OVERVIEW OF LITERATURE: Minimally invasive transforaminal lumbar interbody fusion (MTLIF) is associated with less blood loss, shorter hospital stay, and less pain. However, it has concerns like increased radiation exposure, steep learning curve, and instrumentation cost. We modified the MTLIF technique by direct freehand insertion of pedicle screws using stab incisions without tubular retractors. METHODS: The study included 24 patients in the modMOTLIF group and 27 patients in the OTLIF group. The average follow-up period was 25.6 months. Clinical outcomes were measured using Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores. Serial X-rays were acquired at 1, 3, 6, 12, and 24 months to assess the union and presence of instability. We also compared blood loss and length of hospital stay in both groups. RESULTS: All patients showed progressive improvement in VAS and ODI scores. No differences were observed in the preoperative and postoperative ODI and VAS leg scores between the groups. The immediate postoperative VAS back score was significantly higher in the OTLIF group than in the modMOTLIF group; however, no difference was observed at 1 and 2 years. Radiological analysis showed nonunion in one and two patients in the OTLIF and modMOTLIF groups, respectively. The average blood loss was 63 mL in the mod-MOTLIF group and 254 mL in the OTLIF group. The mean hospital stay was 3 days for the modMOTLIF group and 5 days for the OTLIF group. CONCLUSIONS: modMOTLIF was associated with reduced blood loss and shorter hospital stay compared with OTLIF. No significant differences were observed in the clinical and radiological outcomes between the groups after 2 years despite reduced back pain in the immediate postoperative period in patients who underwent modMOTLIF.

Evaluación funcional de la reparación del tendón del supraespinoso comparando técnica mínimamente invasiva contra técnica abierta / Functional evaluation of the supraspinatus tendon repair comparing mini-open and open techniques

Resumen: Objetivo: Comparar dos técnicas quirúrgicas para la resolución del síndrome de hombro doloroso con lesión parcial o total del tendón del supraespinoso (SPS/RTS). Métodos: Pacientes con diagnóstico de lesión completa del tendón del supraespinoso que requirieron reparación quirúrgica y descompresión subacromial. Un grupo fue tratado con acromioplastía y plastía del tendón con técnica abierta (G1) y otro por vía artroscópica más plastía del tendón por abordaje mínimamente invasivo (G2). La asignación de la técnica quirúrgica no fue aleatoria, sino de acuerdo con la preferencia del cirujano. El desenlace principal fue la valoración funcional a 12 meses postquirúrgicos con la escala de UCLA. Comparamos el tiempo quirúrgico, tiempo anestésico, sangrado operatorio y complicaciones inmediatas. Se analizaron promedios y desviaciones estándar para variables cuantitativas y porcentajes para variables cualitativas. Se realizó prueba de U de Mann-Whitney para comparar rangos de grupos no relacionados. Resultados: Fueron tratados en el G1 32 individuos y en el G2 13 sujetos. No hubo diferencias en edad, género, comorbilidades y tiempo de evolución previo al tratamiento quirúrgico. Se encontró mejor función en el grupo G2 de acuerdo con la escala de UCLA (p = 0.032). No hubo diferencias en el tiempo quirúrgico (60 contra 80 min., p = 0.12) ni anestésico (120 contra 97 min., p = 0.12); sangrado total (50 ml ambos, p = 0.09), ni días de hospitalización (dos contra uno, p = 0.81). No hubo complicaciones inmediatas. Conclusiones: La reparación por artroscopía más abordaje mínimamente invasivo para el pinzamiento subacromial y del tendón del supraespinoso parece dar mejores resultados clínicos en la recuperación, funcionalidad y satisfacción de la persona.

Abstract: Objective: To compare two surgical techniques to address the painful shoulder syndrome with partial or total supraspinous tendon tear. Methods: Patients with a diagnosis of complete supraspinous tendon tear who required surgical repair and subacromial decompression. One group was treated with acromioplasty and tendon plasty using an open approach (G1), and the second one underwent arthroscopy with tendon plasty using a minimally-invasive approach (G2). The surgical approach was not decided at random, but was based on the surgeon's preference. The major outcome was functional assessment at postoperative month 12 using the UCLA scale. The variables compared were the operative time, anesthesia time, intraoperative bleeding, and immediate complications. Means and standard deviations were analyzed for the quantitative variables, and percentages for the qualitative variables. The U Mann-Whitney test was used to compare the ranges of non-related groups. Results: Thirty-two patients were included in G1, and 13 in G2. No differences were found in age, gender, comorbid conditions, and the time elapsed before surgical treatment. G2 patients were found to have better function according to the UCLA scale (p = 0.032). No differences were reported in the operative time (60 versus 80 minutes, p = 0.12), anesthesia time (120 versus 97 minutes, p = 0.12), total bleeding (50 ml in both groups, p = 0.09), or length of stay (2 versus 1, p = 0.81). No immediate complications were reported. Conclusions: Arthroscopic repair plus a minimally-invasive approach to treat subacromial impingement and supraspinous tendon tear seems to provide better clinical outcomes based on function recovery and patient satisfaction.

Safety and Efficacy of Mini Open Transforaminal Lumbar Interbody Fusion

OBJECTIVE: Mini-transforaminal lumbar interbody fusion (Mini-TLIF) and other minimally invasive approaches introduced for the purpose of treating lumbar degenerative disc disease and instability are achieving high success and safety rates as the conventional approaches. Moreover, it has less soft tissue damage, minimal blood loss, and less hospital stay. METHODS: A prospective study was conducted from 2012 to 2014 on 28 patients who were subjected to Mini-open TLIF combined with transpedicular screw fixation for spondylolisthesis and degenerative disc disease. Two paramedian approaches were done, 4 cm for each, to insert the pedicular screws, along with inserting unilateral TLIF cage with autologous bone graft. Decompression was done either unilateral or bilateral according to the patient side of radiculopathy. Sixteen patients (57.2%) were diagnosed with degenerative spondylolisthesis, 7 patients (25%) were diagnosed with isthmic type spondylolisthesis, and 5 patients (17.8%) were diagnosed with degenerative disc disease, 2 of them(7.1%) had previous operations at the same level. Twenty patients (71.4%) were operated at the L4/5 level, and 8 patients (28.6%) at the L5/S1 level. RESULTS: All patients were able to ambulate the next day of surgery. The mean estimated blood loss was 251.79mL. The average hospital stay was 4.14 days. The average follow-up was 9 months. The mean visual analog scale was 1.86 at discharge, 1.68 after 3 months, and 1.38 after 6 months. After 6 months of the operation, MacNab's criteria were good in 23 patients and excellent in 5 patients. We had one case with transient weakness, 2 cases of screw malposition without clinical manifestations, and one case of infection. CONCLUSION: Mini-TLIF approach is an efficient and safe approach for treating instability and degenerative diseases of the lumbar spine. The clinical outcome is encouraging and it may be an operation of choice for lumbar spinal fusion in selected patients.

Anterolateral Mini-open Fixation with a Patch Augmentation for Latissimus Dorsi Tendon Transfer in Irreparable Rotator Cuff Tears: Technical Note

Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.

Anterolateral Mini-open Fixation with a Patch Augmentation for Latissimus Dorsi Tendon Transfer in Irreparable Rotator Cuff Tears: Technical Note

Latissimus dorsi tendon transfer is a well-established method for treatment of irreparable posterosuperior rotator cuff tears. We report on an anterolateral mini-open technique with a porcine dermal patch augmentation for latissimus dorsi tendon transfer. Use of this technique would result in avoidance of deltoid damage by anterolateral mini-open approach and reduction of failure rate by patch augmentation.

Mini-Open Suture Bridge Repair with Porcine Dermal Patch Augmentation for Massive Rotator Cuff Tear: Surgical Technique and Preliminary Results

BACKGROUND: The aim of this study was to describe the mini-open suture bridge technique with porcine dermal patch augmentation for massive rotator cuff tear and to assess preliminary clinical and radiological results. METHODS: Five patients with massive rotator cuff tear for which it was not possible to restore the anatomical footprint underwent mini-open suture bridge repair using a porcine dermal patch. The patients' average age was 53.4 years (range, 45 to 57 years), and the average duration of follow-up was 20.6 months (range, 14 to 26 months). Patients were evaluated with preoperative and postoperative outcome measures, including a visual analog scale (VAS) for pain, the University of California Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons (ASES) score. The structural integrity of repaired rotator cuffs was assessed by magnetic resonance imaging 6 months postoperatively. RESULTS: The average VAS pain score, UCLA score, and ASES score improved from 6.8, 15.4, and 39.4 preoperatively to 0.8, 31.2, and 86.4 postoperatively (p = 0.041, 0.042, and 0.043, respectively). Magnetic resonance images obtained at an average of 8 months after surgery showed that four patients had intact repair integrity with graft incorporation. One patient had a re-tear with partial healing but still had a satisfactory clinical outcome. There was no intraoperative or postoperative complication in any patient. CONCLUSIONS: Mini-open suture bridge repair with porcine dermal patch augmentation can be an option in young patients with high physical demands and massive rotator cuff tears for which it is not possible to restore the anatomical footprint.

An Extremely Giant Lumbar Schwannoma: New Classification (Kotil) and Mini-Open Microsurgical Resection

Purely extradural giant lumbar schwannomas are rare lesions. Classification of these tumors is performed according to the sizes and spills and is named the modified Sridhar's classification. The management of these tumors has traditionally been performed by combined antero-posterior large or two-stage exposures. This combined exposure has many disadvantages. Recent reports have demonstrated the safety and efficacy of removal of these tumors using mini-open micro surgical resection for the schwannomas, but the safety and efficacy have not been established for extremely large giant tumors. We report a case of a giant L4 dumb-bell schwannoma successfully resected through a mini-open micro surgical resection. These neoplasms can be safely and effectively treated with mini-open techniques. Reduction in blood loss, hospitalization, and tissue disruption may be potential benefits of this approach. We discuss the technical details of this surgical approach along with the limitations and possible complications. In addition, this study is included in the current schwannoma (Kotil) classification.

An Extremely Giant Lumbar Schwannoma: New Classification (Kotil) and Mini-Open Microsurgical Resection

Purely extradural giant lumbar schwannomas are rare lesions. Classification of these tumors is performed according to the sizes and spills and is named the modified Sridhar's classification. The management of these tumors has traditionally been performed by combined antero-posterior large or two-stage exposures. This combined exposure has many disadvantages. Recent reports have demonstrated the safety and efficacy of removal of these tumors using mini-open micro surgical resection for the schwannomas, but the safety and efficacy have not been established for extremely large giant tumors. We report a case of a giant L4 dumb-bell schwannoma successfully resected through a mini-open micro surgical resection. These neoplasms can be safely and effectively treated with mini-open techniques. Reduction in blood loss, hospitalization, and tissue disruption may be potential benefits of this approach. We discuss the technical details of this surgical approach along with the limitations and possible complications. In addition, this study is included in the current schwannoma (Kotil) classification.

Mini-Open Approach for Direct Lateral Lumbar Interbody Fusion

STUDY DESIGN: Retrospective analysis. PURPOSES: To introduce the mini-open lateral approach for the anterior lumbar interbody fusion (ALIF), and to investigate the advantages, technical pitfalls and complications by providing basic knowledge on extreme lateral interbody fusion (XLIF) or direct lumbar interbody fusion (DLIF). OVERVIEW OF LITERATURE: Recently, minimally invasive lateral approach for the lumbar spine is revived and receiving popularity under the name of XLIF or DLIF by modification of mini-open method when using the sequential tubular dilator and special expandable retractor system. METHODS: Seventy-four patients who underwent surgery by the mini-open lateral approach from September 2000 to April 2008 with various disease entities were included. Blood losses, operation times, incision sizes, postoperative time to mobilization, length of hospital stays, technical problems and complications were all analyzed. RESULTS: The blood losses and operation times of patients who underwent simple ALIF were 61.2 mL and 86 minutes for one level, 107 mL and 106 minutes for two levels, 250 mL and 142.8 minutes for three levels, and 400 mL and 190 minutes for four levels of fusion. The incision sizes were on average 4.5 cm for one level, 6.3 cm for two levels, 8.5 cm for three levels and 10.0 cm for four levels of fusion. The complications were retroperitoneal hematoma (2 cases), pneumonia (1 case) and transient lumbosacral plexus palsy (3 cases). CONCLUSIONS: Trials of mini-open lateral approach would be helpful before the trial of XLIF or DLIF. However, special attention is required for complications such as transient lumbosacral plexus palsy.

The Efficacy of Carpal Tunnel Release with Mini-Open Incision / 고신대학교의과대학학술지

OBJECTIVES: We evaluated the effects of carpal tunnel release with a mini-open incision by analyzing symptom improvement. METHODS: We retrospectively reviewed 64 carpal tunnel syndrome patients who underwent carpal tunnel release with mini-open incisions between January 2001 and December 2010. The 22 males and 42 females had a mean age of 49 years and a mean follow-up of 12 months. We analyzed postoperative symptoms using The Michigan Hand Outcome Questionnaire. RESULTS: Patients reported complete resolution of their symptoms, and some patients who had presented with residual symptoms improved gradually. No complications or scar hypersensitivity were observed. MHQ(Michigan Hand outcomes Questionnaire) scores improved significantly between preoperative and postoperative 6 months and 12 months. CONCLUSIONS: Carpal tunnel release with mini-open incision provides a clinically effective, reliable and safe procedure.

Clinical Outcomes of Combinations of Locking Compression Plate Fixation through Minimally Invasive Precutaneous Plate Osteosynthesis and Interfragmentary Screw Fixation in Distal Tibia Fracture / 대한족부족관절학회지

PURPOSE: To analyze the outcome of distal tibia fracture treated with the Distal Tibia LCP with combination of interfragmentary screw. MATERIALS AND METHODS: Between January 2008 and March 2012, data of 34 patients with fracture of distal tibia treated with the Distal Tibia LCP with or without combination of interfragmentary screws were reviewed. There were 17 males and 17 females with an average age of 51.8 years (range, 18~77 years). Radiographic union time and time from surgery until ability to full weight bearing were measured and compared. Callus index was measured as quotient of callus thickness and diameter of corticalis both in AP and sagittal direction. RESULTS: 12 fractures were treated with interfragmentary screws and 22 fractures were treated with bridging plate alone. In interfragmentary fixation group, time to full weight bearing was 14 weeks versus 15.75 weeks without screw. Callus index at bearing was not significantly lesser in patients with screw compated with those without, but callus index difference at posterative 4weeks was sigficant. Radiologic union time was 11.3 weeks in interfragmentary fixation group and 12.58 weeks without screw. CONCLUSION: The osteosynthesis with the Distal tibia LCP with combination of interfragmentary screw seems to be more stable in postoperative 4weeks than Distal tibia LCP alone, expecting to earlier ROM exercise and rehabilitation.

Video-Assisted Thoracoscopic Surgery Plus Lumbar Mini-Open Surgery for Adolescent Idiopathic Scoliosis

PURPOSE: The objectives of this study are to describe the outcome of adolescent idiopathic scoliosis (AIS) patients treated with Video Assisted Thoracoscopic Surgery (VATS) plus supplementary minimal incision in the lumbar region for thoracic and lumbar deformity correction and fusion. MATERIALS AND METHODS: This is a case series of 13 patients treated with VATS plus lumbar mini-open surgery for AIS. A total of 13 patients requiring fusions of both the thoracic and lumbar regions were included in this study: 5 of these patients were classified as Lenke type 1A and 8 as Lenke type 5C. Fusion was performed using VATS up to T12 or L1 vertebral level. Lower levels were accessed via a small mini-incision in the lumbar area to gain access to the lumbar spine via the retroperitoneal space. All patients had a minimum follow-up of 1 year. RESULTS: The average number of fused vertebrae was 7.1 levels. A significant correction in the Cobb angle was obtained at the final follow-up (p = 0.001). The instrumented segmental angle in the sagittal plane was relatively well-maintained following surgery, albeit with a slight increase. Scoliosis Research Society-22 (SRS-22) scores were noted have significantly improved at the final follow-up (p < 0.05). CONCLUSION: Indications for the use of VATS may be extended from patients with localized thoracic scoliosis to those with thoracolumbar scoliosis. By utilizing a supplementary minimal incision in the lumbar region, a satisfactory deformity correction may be accomplished with minimal post-operative scarring.

Mini-open Rotator Cuff Repair Using Anterolateral Approach

PURPOSE: To introduce mini-open rotator cuff repair using the anterolateral approach and evaluate its clinical outcomes and effectiveness. MATERIALS AND METHODS: 59 consecutive cases of rotator cuff tearing which were treated with mini-open repair utilizing the anterolateral approach were evaluated. The population comprised 39 men and 20 women, with an average age of 56.6 years. An average follow-up time period was 26 months. Clinical outcomes were analyzed based on VAS, ADL, and ASES scores. RESULTS: The average respective VAS, ADL, and ASES scores improved from 7.04, 12.37, and 35.32 preoperatively to 1.02, 27.20, and 90.08 postoperatively (p=0.000). There were 41 excellent, 11 good, 2 fair, and 5 poor results. There were satisfactory results in 52 cases (88.1%). There were no statistically significant differences between the final ASES scores and age, sex, duration of symptoms, tear size, and preoperative stiffness (p>0.05). CONCLUSION: Mini-open rotator cuff repair using the anterolateral approach effective in providing better visualization.

Mini-open Muscle Resection Procedure under Local Anesthesia for Lateral and Medial Epicondylitis

BACKGROUND: This study examined the clinical results of surgical treatment using a mini-open muscle resection procedure under local anesthesia for intractable lateral or medial epicondylitis. METHODS: Forty two elbows (41 patients) were treated surgically for lateral or medial epicondylitis. The indication for surgery was refractory pain after six months of conservative treatment, or a history of more than three local injections of steroid, or severe functional impairment in the occupational activities. The treatment results were assessed in terms of the pain using the visual analogue scale (VAS), Roles & Maudsley score, and Nirschl & Pettrone grade. RESULTS: The preoperative VAS scores of pain were an average of 5.36 at rest, 6.44 at daily activities, and 8.2 at sports or occupational activities. After surgery, the VAS scores improved significantly (p < 0.01): 0.3 at rest, 1.46 at daily activities, and 2.21 at sports or occupational activities. The preoperative Roles & Maudsley score was acceptable in 6 cases, and poor in 36 cases, which was changed to excellent in 23 cases, good in 16 cases, acceptable in 3 cases after surgery. According to the grading system by Nirschl & Pettrone, 23 cases were excellent, 18 cases were good, and the remaining 1 case was fair. Overall, 41 cases (97.6%) achieved satisfactory results. Postoperative complications were encountered in three cases. Subcutaneous seroma due to the leakage of joint fluid in two patients was managed by additional surgery and suction drainage, and resulted in a satisfactory outcome. One patient complained of continuous pain on occupational activity, but her pain at rest was improved greatly. CONCLUSIONS: The mini-open muscle resection procedure under local anesthesia appears to be one of effective methods for intractable lateral or medial epicondylitis.

Arthroscopically Assisted Mini-Open Rotator Cuff Repair for Rotator Cuff Tears / 中国微创外科杂志

Objective To study clinical results of arthroscopically assisted mini-open rotator cuff repair.Methods Twenty-two patients with rotator cuff tears were treated with arthroscopically assisted mini-open rotator cuff repair from March 1999 to March 2004.Thirteen patients underwent arthroscopic inspection,mini-open subacromial decompression,and rotator cuff repair.Nine patients underwent arthroscopic subacromial decompression and mini-open repair.The UCLA scoring system was used for outcome assessment.Results The 22 patients were followed for 12-72 months(mean,47 months).The UCLA scores were increased from 14.8?3.8 preoperatively to 32.0?4.7 postoperatively(t=15.086,P=0.000).The results were classified as excellent in 7 patients,good in 13 patients,fair in 1 patient,and poor in 1.Twenty patients were satisfied with the operative outcomes.Conclusions Arthroscopically assisted mini-open rotator cuff repair is an effective procedure for rotator cuff tears,with simplicity of performance and little invasion.

Arthroscopic Versus Mini-Open Rotator Cuff Repair: Comparison of Clinical Results / 대한정형외과학회잡지

PURPOSE: To compare the clinical results of an arthroscopic rotator cuff repair with those of a mini-open repair. MATERIALS AND METHODS: Sixty-three patients with a rotator cuff tear were enrolled in this study. Thirty patients had an arthroscopic repair and 33 patients underwent a mini-open repair. The average age was 50 years (range, 23-74) in the arthroscopic group and 50 years (range, 38-69) in the mini-open group. In the arthroscopic group, 8 patients had small-sized tears (0.05], the range of motion, muscle strength, patient's satisfaction, the ASES score [91.7 vs. 88.6, p>0.05] and the UCLA score [32.4 vs. 31.2, p>0.05] were compared. The size of the tear did not produce different results. In the arthroscopic group, the tendon tore again in one patient, and one anchor-related complication was noted. In the mini-open group, one patient developed a stiff shoulder. CONCLUSION: An arthroscopic and a mini-open repair of rotator cuff tears produced similar clinical results and the size of the tear had little effect. The clinical results depend on the surgical technique and the patient's condition, rather than the method of repair.

The Posterior Decompression and Posterior Lumbar Interbody Fusion Using a Mini-open Technique: New Suggestion of Minimally Invasive Technique A Preliminary Report / 대한정형외과학회잡지

PURPOSE: To introduce mini-open posterior decompression with posterior lumbar interbody fusion (PLIF) and to assess its clinical outcomes. MATERIALS AND METHODS: Eight patients who underwent L4-5 posterior decompression with PLIF using a mini-open technique were followed up for an average 8 months. Three patients had degenerative lumbar spinal stenosis and five patients had spinal stenosis with degenerative spondylolisthesis. We performed posterior decompression with PLIF through a mini-incision (2.5 cm paramedian incision at the both sides) including percutaneous pedicle screw fixation. The operative time, amount of blood loss and complications were analyzed. Clinical outcomes were assessed by using McNab criteria and VAS (visual analogue scale) for postoperative back pain. RESULTS: The mean operative time was 172.5 min (range, 130-235 min). The mean amount of intraoperative blood loss was 178.1 mL (range, 95-310 mL). All procedures were completed without transfusion. VAS for back pain rapidly reduced from 10 on the immediate postoperative day to 3 on the third day and 2 on the seventh day. At the last follow up, five patients had no back pain and the three remaining patients had a VAS 0.75. The clinical outcomes were excellent in 5 patients and good in 3 patients. CONCLUSION: Mini-open posterior decompression and the PLIF technique offer a useful minimally-invasive modality for the treatment of single level spinal stenosis.

Laparoscopy Assisted Miniopen Lateral Approach for Anterior Lumbar Interbody Fusion / 대한척추외과학회지

STUDY DESIGN: A new approach to anterior lumbar interbody fusion (ALIF). OBJECTIVE: To investigate the advantages, technical pitfalls and complications of the laparoscopy assisted miniopen lateral approach. SUMMARY OF LITERATURE REVIEW: Several kinds of miniopen approach or laparoscopy are now used for ALIF. MATERIALS AND METHODS: Thirty-five patients with various disease entities were included. Blood loss, operation time, incision size, postoperative time to mobilization, length of hospital stay, technical problems and complications were analyzed. RESULTS: Using this approach, T12 to L5 can be reached sub-diaphragmatically. Blood loss and operation time were 45.7 cc and 82.8 minutes for 1 level, 103.2 cc and 107.6 minutes for two levels, 272.5 cc and 150 minutes for three levels, and 520 cc and 190 minutes for four-level-fusion, respectively, The incision sizes were on average 4.1cm for 1 level, 6.2 cm for 2 levels, 8.2 cm for 3 levels and 10.1 cm for four-level-fusion. Complications were retroperitoneal hematoma in 2 cases, pneumonia in 1 case and transient lumbosacral plexus palsy in 3 cases. CONCLUSION: The laparoscopy assisted miniopen lateral approach is an advantageous approach with a very short learning curve. However, special attention is required if complications such as transient lumbosacral plexus palsy are to be avoided.

Mini-Open Approach for Rotator Cuff Repair: Bone Tunnel Versus Suture Anchor Techniques / 대한정형외과학회잡지

PURPOSE: We evaluated and compared the clinical results of mini-open approaches using bone tunnel and suture anchor techniques for rotator cuff repair. MATERIALS AND METHODS: We reviewed 31 cases with full thickness rotator cuff tears repaired using an arthroscopically assisted mini-open technique between February 1997 and August 1999. This study included only those patients who had a minimum follow-up of two years. Group A using bone tunnel technique was 14 cases, and group B using suture anchor technique was 17 cases. We analyzed the patients according to the University of California at Los Angeles shoulder rating scale. RESULTS: Pain score improved from 2.9 preoperatively to 8.4 postoperatively in group A, and 2.6 to 8 in group B. Function score improved from 3.6 to 8.6 in group A, and 3.4 to 7.9 in group B. Strength score improved from 4 to 4.8 in group A, and 3.8 to 4.5 in group B. Overall, 85% of group A and 82% of group B had satisfactory results. However functional outcomes did not differ signifcantly between the two groups (p>0.05). And, any failures of suture anchor within the bone or "saw through "phenomenon in the bone tunnel were not observed. CONCLUSION: Our results suggest that unless bone quality of the tuberosity is poor, both bone tunnel and suture anchor technique are useful for rotator cuff repair.