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Heeren Makanji, Andrew J Schoenfeld, Amandeep Bhalla, Christopher M Bono
PURPOSE: Lumbar fusion for degenerative disorders is among the most common spine surgical procedures performed. The purpose of this study was to analyze fusion, complications, and clinical success for lumbar fusion performed with various surgical techniques as reported in the literature from 2000 to 2015 and compare with previous critical analysis of outcomes from 1980 to 2000. METHODS: A systematic review of the literature to identify all studies of adult lumbar fusion for degenerative disorders published between January 1, 2000, and August 31, 2015, was performed adhering to PRISMA guidelines...
March 15, 2018: European Spine Journal
Ahilan Sivaganesan, Brandon Hirsch, Frank M Phillips, Matthew J McGirt
Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings...
March 12, 2018: Neurosurgery
Sven Hoppe, Christoph E Albers, Tarek Elfiky, Moritz C Deml, Helena Milavec, Sebastian F Bigdon, Lorin M Benneker
The aim of this study was to assess the performance of a new vacuum plasma sprayed (VPS) titanium-coated carbon/polyetheretherketone (PEEK) cage under first use clinical conditions. Forty-two patients who underwent a one or two segment transforaminal lumbar interbody fusion (TLIF) procedure with a new Ca/PEEK composite cage between 2012 and 2016 were retrospectively identified by an electronic patient chart review. Fusion rates (using X-ray), patient's satisfaction, and complications were followed up for two years...
March 14, 2018: Journal of Functional Biomaterials
A Tateen, J Bogert, H Koller, A Hempfing
BACKGROUND: Surgical correction of ASD can be challenging. The indication for surgery is individual and after specification of the therapeutic goals, detailed planning of the surgery is essential to achieve a good postoperative result. COMPLICATIONS AND INDICATION: The reasons for the comparatively high complication rate are well investigated and are often located at the lumbosacral junction. In addition to negative general factors like osteoporosis, especially undercorrection of the sagittal profile and insufficient lumbo-pelvic stabilization are causative...
March 5, 2018: Der Orthopäde
Go Kubota, Hiroto Kamoda, Sumihisa Orita, Kazuhidee Inage, Michihiro Ito, Masaomi Yamashita, Takeo Furuya, Tsutomu Akazawa, Yasuhiro Shiga, Seiji Ohtori
Study Design: Retrospective case series. Purpose: To examine the efficacy of platelet-rich plasma (PRP) for bone fusion in transforaminal lumbar interbody fusion (TLIF) using local bone grafting. Overview of Literature: Several authors have reported the efficacy of PRP for bone union in animal models. However, the use of PRP for bone fusion in TLIF surgery has not been fully explored. Methods: Twenty patients underwent single-level TLIF surgery because of L4 spondylolisthesis...
February 2018: Asian Spine Journal
Marko Tomov, Kevin Tou, Rose Winkel, Ross Puffer, Mohamad Bydon, Ahmad Nassr, Paul Huddleston, Michael Yaszemski, Bradford Currier, Brett Freedman
Study Design: Retrospective case-control study using prospectively collected data. Purpose: Evaluate the impact of liposomal bupivacaine (LB) on postoperative pain management and narcotic use following standardized single-level low lumbar transforaminal lumbar interbody fusion (TLIF). Overview of Literature: Poor pain control after surgery has been linked with decreased pain satisfaction and increased economic burden. Unfortunately, opioids have many limitations and side effects despite being the primary treatment of postoperative pain...
February 2018: Asian Spine Journal
Arvind G Kulkarni, Shashidhar Bangalore Kantharajanna, Abhilash N Dhruv
Study Design: Retrospective case series. Purpose: To compare minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) outcomes in primary and revision surgeries. Overview of Literature: Revision spinal fusion is often associated with an increased risk of approach-related complications. Patients can potentially benefit from the decreased approach-related morbidity associated with MI-TLIF. Methods: Sixty consecutive MI-TLIF patients (20 failed back [Fa group], 40 primary [Pr group]) who underwent surgery between January 2011 and May 2012 were reviewed after Institutional Review Board approval to compare operative times, blood loss, complications, Oswestry Disability Index (ODI) scores, and Visual Analog Scale (VAS) scores for back and leg pain before surgery and at the last follow-up...
February 2018: Asian Spine Journal
Zhenjun Zhang, Hui Li, Guy R Fogel, Dingding Xiang, Zhenhua Liao, Weiqiang Liu
In lumbar interbody fusion, a porous additive manufactured (AM) cage can provide more desirable stiffness, and may be beneficial to bone ingrowth. The biomechanical influence of porous cages on stability, subsidence, and facet contact force has not been fully described. The aim of this study was to verify biomechanical effects of porous cages. Surgical finite element (FE) model of transforaminal lumbar interbody fusion (TLIF) was constructed. The partially porous (PP) cages and fully porous (FP) cages were applied...
February 23, 2018: Computers in Biology and Medicine
Xin Zhao, Lin Du, Youzhuan Xie, Jie Zhao
OBJECTIVE: Here we used a finite element (FE) analysis to investigate the biomechanical changes caused by transforaminal lumbar interbody fusion (TLIF) at the L4-L5 level by lumbar lordosis (LL) degree. METHODS: A lumbar FE model (L1-S5) was constructed based on computed tomography scans of a 30-year-old healthy male volunteer (pelvic incidence = 50°, LL = 52°). We investigated the influence of LL on the biomechanical behavior of the lumbar spine after TLIF in L4-L5 fusion models with 57°, 52°, 47°, and 40° LL...
February 21, 2018: World Neurosurgery
Michael A Bohl, Randy J Hlubek, U Kumar Kakarla, Steve W Chang
BACKGROUND: A major drawback to the use of cortical bone trajectory pedicle screws (CBTPS) with traditional posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) grafts is that traditional graft insertion trajectories require a wider posterior exposure. This wider exposure, beyond the limits otherwise required for CBTPS placement, negates a primary benefit of CBTPS fixation. OBJECTIVE: To define an alternative surgical technique for interbody graft placement that, when used in conjunction with CBTPS fixation, permits both minimal soft tissue dissection and optimal graft placement...
February 17, 2018: World Neurosurgery
Brittany E Haws, Benjamin Khechen, Ankur S Narain, Fady Y Hijji, Kaitlyn L Cardinal, Jordan A Guntin, Kern Singh
STUDY DESIGN: Retrospective Analysis OBJECTIVE.: The aim of this study was to determine whether an association between increased acute pain, postoperative time, and direct hospital costs exists between the use of iliac crest bone grafting (ICBG) and bone morphogenic protein (BMP)-2 following a primary, single-level minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA: ICBG has been associated with enhanced fusion rates...
February 16, 2018: Spine
Rong-Xue Hao, Hui Zhou, Hao Pan, Jun Yue, Hui-Guo Chen, He-Jie Yang, Gao-Yong Jia, Dong Wang, Yan Lin, Hua-Zi Xu
OBJECTIVE: To investigate the surgical outcome of unilateral pedicle screw(UPS) after TLIF technique combined with contralateral percutaneous transfacet screw(PTS) fixation vs bilateral pedicle screws(BPS) fixation in treatment of degenerative lumbar disease. METHODS: From January 2009 to June 2012, 46 patients with degenerative lumbar diseases, including 30 males and 16 females with an average age of 51.5 years old, who were divided into two groups according to different fixation methods...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jay M Levin, Joseph E Tanenbaum, Michael P Steinmetz, Thomas E Mroz, Samuel C Overley
BACKGROUND CONTEXT: Lumbar fusion is an effective and durable treatment for symptomatic lumbar spondylolisthesis, however the current literature provides insufficient evidence to recommend an optimal surgical fusion strategy. PURPOSE: To compare the clinical outcomes, fusion rates, blood loss, and operative times between open posterolateral lumbar fusion (PLF) alone and open transforaminal lumbar interbody fusion + posterolateral fusion (TLIF) for spondylolisthesis...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
Khalid M I Salem, Aditya P Eranki, Scott Paquette, Michael Boyd, John Street, Brian K Kwon, Charles G Fisher, Marcel F Dvorak
OBJECTIVE The study aimed to determine if the intraoperative segmental lordosis (as calculated on a cross-table lateral radiograph following a single-level transforaminal lumbar interbody fusion [TLIF] for degenerative spondylolisthesis/low-grade isthmic spondylolisthesis) is maintained at discharge and at 6 months postsurgery. METHODS The authors reviewed images and medical records of patients ≥ 16 years of age with a diagnosis of an isolated single-level, low-grade spondylolisthesis (degenerative or isthmic) with symptomatic spinal stenosis treated between January 2008 and April 2014...
February 16, 2018: Journal of Neurosurgery. Spine
Charles D Rosen, P Douglas Kiester, Thay Q Lee
We conducted a study to determine the common characteristics of patients who developed radiculopathy symptoms and corresponding heterotopic ossification (HO) from transforaminal lumbar interbody fusions (TLIF) using recombinant human bone morphogenetic protein 2 (rhBMP-2). HO can arise from a disk space with rhBMP-2 use in TLIF. Formation of bone around nerve roots or the thecal sac can cause a radiculopathy with a consistent pattern of symptoms. We identified 38 patients (26 males, 12 females) with a mean (SD) age of 50...
January 2018: American Journal of Orthopedics
Xin Zhao, Chen Chen, Tangjun Zhou, Jie Mi, Lin Du, Zhanrong Kang, Jianming Huang, Kai Zhang, Xiaojiang Sun, Jie Zhao
PURPOSE: The purpose of this study was to investigate the position of single cage inserted using oblique-oriented technique in transforaminal lumbar interbody fusion (TLIF) on digital images of computed tomography (CT). METHODS: From January to August 2015, 44 consecutive patients with degenerative lumbar disease who underwent TLIF in the L4/5 level were retrospectively studied in our department. The single cage was inserted using the oblique-oriented technique; as the main purpose of the study, its position was analyzed using post-operative digital computed tomography images...
February 11, 2018: International Orthopaedics
Kazuyoshi Kobayashi, Kei Ando, Fumihiko Kato, Tokumi Kanemura, Koji Sato, Yudo Hachiya, Yuji Matsubara, Mitsuhiro Kamiya, Yoshihito Sakai, Hideki Yagi, Ryuichi Shinjo, Yoshihiro Nishida, Naoki Ishiguro, Shiro Imagama
PURPOSE: Posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) can have complications that require reoperation. The goal of the study was to identify risk factors for reoperation within 2 years after PLIF/TLIF. METHODS: A retrospective analysis of a prospective multicenter database was performed for patients who underwent PLIF/TLIF. A total of 1363 patients (689 males and 674 females) were identified, with an average age of 65.9 years old...
February 8, 2018: European Spine Journal
Frederick Galla, Dirk Wähnert, Ulf Liljenqvist
INTRODUCTION: A balanced ratio of the main parameters of lumbar lordosis (LL) and pelvic incidence (PI) has high clinical relevance. A postoperative mismatch of LL and PI has been described in the literature to be associated with an inferior clinical outcome and higher postoperative revision rates. The aim of this retrospective, radiological study is to evaluate the magnitude of relordosing in mono-/bisegmental TLIF spondylodesis affecting the spino-pelvic alignment and the main contributing factors...
February 7, 2018: European Spine Journal
Zachary Tataryn, Kenan Alkhalili, James T Kryzanski
Traditional posterior lumbar approaches in a transforaminal lumbar interbody fusion (TLIF) require subperiosteal dissection of bilateral paraspinal muscles to provide adequate exposure. This may traumatize the multifidus muscle and its afferent innervations leading to postoperative paraspinal muscle atrophy. Minimizing such intraoperative trauma has been identified as an important factor in the reduction of postoperative lumbar pain. An approach via a blunt dissection through Wiltse's plane, which lies between the longissimus and multifidus muscles, may minimize postoperative pain...
November 23, 2017: Curēus
Tao Lan, Shi-Yu Hu, Yuan-Tao Zhang, Yu-Chen Zheng, Rui Zhang, Zhe Shen, Xin-Jian Yang
BACKGROUND: The purpose of this meta-analysis was to compare the efficacy and safety in the management of lumbar diseases performed by either posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). SUMMARY OF BACKGROUND DATA: Interbody fusion was considered as "gold standard" in the treatment of lumbar degenerative diseases. Both PLIF and TLIF have been advocated and it remains controversial as to the best operative technique. METHODS: The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies up to September 2017...
January 21, 2018: World Neurosurgery
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