Transforaminal Lumbar Interbody Fusion for the Treatment of Nonunion after Posterolateral Lumbar Fusion / 대한척추외과학회지
Journal of Korean Society of Spine Surgery
;
: 223-230, 2004.
Article
in Korean
| WPRIM
| ID: wpr-132045
ABSTRACT
STUDY DESIGN:
A retrospective studyOBJECTIVES:
To evaluate the clinical and radiological results of a transforaminal lumbar interbody fusion for the treatment of non-union after a posterolateral spinal fusion. LITERATURE REVIEWSUMMARY:
In the case of nonunion after a posterolateral spinal fusion, the anterior column should be reconstructed. However, due to epidural scarring and fibrosis, the approach to the anterior column by conventional posterior lumbar interbody fusion (PLIF) is difficult. The authors have modified the original transforaminal lumbar interbody fusion (TLIF) developed by Dr. Harms, which offers potential advantages and provides a surgical alternative to the traditional methods. MATERIALS ANDMETHODS:
Between January 2002 and August 2003, 10 cases of TLIF for the treatment of non-unions after a posterolateral spinal fusion were performed. There were 8 male and 2 female cases. The mean age of the patient was 63.3 years, ranging from 53 to 75 years. The levels of the TLIF were the L4-5 and L5-S1 in 9 and 1 cases, respectively. The mean interval between the revision and previous operations was 21.3 months, ranging 12 to 48 months. In the preoperative radiography, bony defect in posterolateral fusion mass, halos around screws and abnormal motions in the stress view were observed. Using the previous midline approach, exposure of the bilateral articular and transverse processes were performed. With a small osteotome, the superior articular process was removed along a line parallel to the superior margins of the pedicular screw head, to allow access to the neural foramen and lateral aspect of the disc space. The TLIF was performed through this space by inserting cages. The loosened screw was replaced by one that was thicker, coupled with a cancellous bone graft in the foramen.RESULTS:
The average operation time and blood loss were 224 min. and 727 cc, respectively. Using Kirkaldy-Willis categories, the results were excellent in 1 case, good in 7, fair in 1 and poor in a further 1 case, with 1 case of nonunion was observed postoperatively.CONCLUSIONS:
The transforaminal lumbar interbody fusion for the treatment of nonunion after a posterolateral spinal fusion is a reliable and safe technique, which seems to have the merit of less morbidity.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Spinal Fusion
/
Fibrosis
/
Radiography
/
Retrospective Studies
/
Cicatrix
/
Transplants
/
Head
Type of study:
Diagnostic study
/
Observational study
Limits:
Female
/
Humans
/
Male
Language:
Korean
Journal:
Journal of Korean Society of Spine Surgery
Year:
2004
Type:
Article
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