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https://www.readbyqxmd.com/read/29351677/use-of-risk-model-for-assessment-of-residents-perception-of-complexity-of-surgical-steps-example-of-modular-component-steps-of-lumbar-spinal-fusion-surgery
#1
Jeffrey S Raskin, Jesse J Liu, Katherine Holste, Sarah Brown, Fran Hardaway, Priscilla Pang, Ahmed M Raslan
BACKGROUND: Quality improvement projects increasingly emphasize standardization of surgical work flow to optimize operative room efficiency. Removing special cause variability resulting from nonsurgical waste is an obvious target; however, resident surgical education must be maintained, even in the setting of process improvement. OBJECTIVE: To describe the impact of resident-identified "risky" or "uncomfortable" procedural steps on operative time during transforaminal lumbar interbody fusion (TLIF)...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29346684/comparing-cortical-trajectory-transforaminal-lumbar-interbody-fusions-against-pedicle-trajectory-transforaminal-lumbar-interbody-fusions-and-posterolateral-fusions-a-retrospective-cohort-study-of-90-day-outcomes
#2
James G Malcolm, Michael K Moore, Falgun H Choksh, Faiz U Ahmad, Daniel Refai
BACKGROUND: The cortical screw (CS) trajectory for pedicle screw placement is believed to require a smaller incision and less tissue dissection resulting in lower blood loss and faster healing; however, this has not yet been confirmed in clinical studies. OBJECTIVE: To compare CS transforaminal lumbar interbody fusions (TLIF), traditional pedicle screw (TPS) trajectory TLIFs, and posterolateral fusion (PLF) without interbody for differences in operative characteristics and complications...
January 13, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29343248/minimally-invasive-versus-open-transforaminal-lumbar-interbody-fusion-in-obese-patients-a-meta-analysis
#3
Qingsong Xie, Jing Zhang, Feng Lu, Hao Wu, Zan Chen, Fengzeng Jian
BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has been employed in increasing cases compared with open TLIF (Open-TLIF). However, it is uncertain whether the advantages of MI-TLIF can also be specifically applied in obese patients. Therefore, the current study was thereby carried out aiming to compare the outcomes of MI-TLIF with those of Open-TLIF in obese patients with lumbar degenerative diseases. METHODS: Electronic databases were systemically retrieved from construction to May 2017...
January 17, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29343035/-comparison-of-percutaneous-endoscopic-lumbar-discectomy-versus-transforaminal-lumbar-interbody-fusion-in-treating-upper-lumbar-disc-herniation
#4
Y W Li, H J Wang, Y S Wang, W Cui, P Zhou, C Li
Objective: To compare the efficacy of percutaneous endoscopic transforaminal discectomy (PTED) and transforaminal lumbar interbody fusion (TLIF) in the treatment of high lumbar disc herniation. Methods: The clinical data of patients with high lumbar disc herniation from February 2010 to February 2015 were retrospective analyzed. According to the inclusion criteria, a total of 63 cases were enrolled, including PTED group 33 cases, TLIF group 30 cases. The improvement of the two groups before and after surgery was assessed by visual analogue scale (VAS) and Oswestry dysfunction index (ODI)...
January 9, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29322970/minimally-invasive-transforaminal-lumbar-interbody-fusion-using-bone-cement-augmented-pedicle-screws-for-lumbar-spondylolisthesis-in-patients-with-osteoporosis-case-series-and-review-of-literature
#5
Venkata Ramesh Chandra Vemula, Bodapati Chandramowliswara Prasad, M A Jagadeesh, Jayachandar Vuttarkar, Sanjeev Kumar Akula
BACKGROUND: Instrumentation in patients with osteoporosis is challenging. Bone cement-augmented fenestrated pedicle screw fixation is a new procedure for fixation in the osteoporotic bone; and, applying minimally invasive techniques to the above is a challenging and novel concept. AIMS: To evaluate the clinical and radiological outcome of minimally invasive spine surgery transforaminal lumbar interbody fusion (MIS-TLIF) in patients with spondylolisthesis and poor bone quality, performed with rigid instrumentation using bone cement [poly(methylmethacrylate)]-augmented fenestrated pedicle screws...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29290133/assessment-of-radiographic-and-clinical-outcomes-of-an-articulating-expandable-interbody-cage-in-minimally-invasive-transforaminal-lumbar-interbody-fusion-for-spondylolisthesis
#6
Lara W Massie, Hesham Mostafa Zakaria, Lonni R Schultz, Azam Basheer, Morenikeji Ayodele Buraimoh, Victor Chang
OBJECTIVE The inability to significantly improve sagittal parameters has been a limitation of minimally invasive surgery for transforaminal lumbar interbody fusion (MIS TLIF). Traditional cages have a limited capacity to restore lordosis. This study evaluates the use of a crescent-shaped articulating expandable cage (Altera) for MIS TLIF. METHODS This is a retrospective review of 1- and 2-level MIS TLIF. Radiographic outcomes included differences in segmental and lumbar lordosis, disc height, evidence of fusion, and any endplate violations...
January 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29229340/an-unusual-case-of-ureteral-perforation-in-minimally-invasive-pedicle-screw-instrumentation-and-review-of-the-literature
#7
Edward Fomekong, Julien Pierrard, Etienne Danse, Bertrand Tombal, Christian Raftopoulos
BACKGROUND: and Importance: Injury of the ureter is a potentially devastating complication most often reported in gynecologic, colorectal, vascular pelvic surgery or endoscopic procedures for ureteric pathologies. We report a rare case of ureteral rupture occurring as a complication of percutaneous pedicle screw placement. CLINICAL PRESENTATION: A 60-year old man complained of unbearable abdominal pain on the day after right L4-L5 transforaminal intervertebral fusion and percutaneous pedicle screw placement...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29222690/risk-factor-of-contralateral-radiculopathy-following-microendoscopy-assisted-minimally-invasive-transforaminal-lumbar-interbody-fusion
#8
Yang Yang, Zhong-Yu Liu, Liang-Ming Zhang, Jian-Wen Dong, Pei-Gen Xie, Rui-Qiang Chen, Bu Yang, Chang Liu, Bin Liu, Li-Min Rong
PURPOSE: Microendoscopy-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is an advantageous method for treating lumbar degenerative disease; however, some patients show contralateral radiculopathy postoperatively. This study aims to investigate its risk factor. METHODS: A total of 130 cases who underwent microendoscopy-assisted MIS-TLIF at L4-5 level were divided into symptomatic and asymptomatic groups according to the presence of postoperative contralateral radiculopathy...
December 8, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29192879/pedicle-screw-placement-accuracy-using-ultra-low-radiation-imaging-with-image-enhancement-versus-conventional-fluoroscopy-in-minimally-invasive-transforaminal-lumbar-interbody-fusion-an-internally-randomized-controlled-trial
#9
Gautam Nayar, Daniel J Blizzard, Timothy Y Wang, Steven Cook, Adam G Back, David Vincent, Isaac O Karikari
OBJECTIVE A previous study found that ultra-low radiation imaging (ULRI) with image enhancement significantly decreases radiation exposure by roughly 75% for both the patient and operating room personnel during minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) (p < 0.001). However, no clinical data exist on whether this imaging modality negatively impacts patient outcomes. Thus, the goal of this randomized controlled trial was to assess pedicle screw placement accuracy with ULRI with image enhancement compared with conventional, standard-dose fluoroscopy for patients undergoing single-level MIS-TLIF...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29174460/long-term-outcomes-of-transforaminal-lumbar-interbody-fusion-in-patients-with-spinal-stenosis-and-degenerative-scoliosis
#10
Swamy Kurra, William F Lavelle, Michael P Silverstein, Jason W Savage, R Douglas Orr
BACKGROUND CONTEXT: Spinal deformity patients may present with complaints related to either the deformity itself or to the manifestations of the coexisting spinal stenosis. There are reports of successful management of lumbar pathology in the absence of global sagittal or coronal imbalance, with limited decompression and fusion, addressing only the symptomatic segment. PURPOSE: Our study examined the long-term outcomes of transforaminal lumbar interbody fusion (TLIF), a less extensive procedure, based on the experience of the senior author over the past ten years...
November 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29162074/the-role-of-cage-height-on-the-flexibility-and-load-sharing-of-lumbar-spine-after-lumbar-interbody-fusion-with-unilateral-and-bilateral-instrumentation-a-biomechanical-study
#11
Lin Du, Xiao-Jiang Sun, Tang-Jun Zhou, Yuan-Chao Li, Chen Chen, Chang-Qing Zhao, Kai Zhang, Jie Zhao
BACKGROUND: One- and two-level lumbar interbody fusion with unilateral instrumentation is as effective as that with bilateral instrumentation. The height of the interbody cage influences the operated segment stability and the fusion technique success. The purpose of this research was to determine the effect of the fusion cage height (i.e. long and short) on both the stability (based on flexibility measures) and load sharing of the unilateral and bilateral instrumented transforaminal lumbar interbody fusion (TLIF) technique...
November 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29158095/sagittal-alignment-as-predictors-of-of-adjacent-segment-disease-after-lumbar-transforaminal-inter-body-fusion
#12
Jin Sun, Hui Huang, Jun-Jie Wang, Na-Xin Fu
OBJECTIVES: The study was carried out to explore the diagnostic value of sagittal measurement for adjacent segment disease after Lumbar transforaminal inter-body fusion(TLIF). METHODS: A total of 163 subjects who adopted TLIFfor lumbar disease , were initially enrolled in the study from July 2013 to August 2017 . Sagittal alignment including thoracic inlet and pine-pelvic parameters were measured by using pre- operative full-length free-standing radiographs. Multivariate logistic regression analysis was performed to evaluate these parameters as diagnostic index for adjacent segment disease (ASD)...
November 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137917/radiation-exposure-with-hybrid-image-guidance-based-minimally-invasive-transforaminal-lumbar-interbody-fusion
#13
Michael M Safaee, Taemin Oh, Murat Pekmezci, Aaron J Clark
The transforaminal lumbar interbody fusion (TLIF) is used for the treatment of back and leg pain secondary to spinal stenosis, degenerative disc disease, and spondylolisthesis. Minimally invasive surgery (MIS) is associated with less estimated blood loss (EBL), decreased length of stay, lower infection rates, and similar outcomes compared to the traditional TLIF. Fluoroscopy time has been reported with MIS-TLIF, but there are limited data on specific radiation dosages. We performed a retrospective analysis of a prospectively acquired cohort of patients undergoing MIS-TLIF...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29114274/outcomes-of-minimally-invasive-surgery-compared-to-open-posterior-lumbar-instrumentation-and-fusion
#14
Low Yong Lee, Zamzuri Idris, Tan Boon Beng, Teo Yian Young, Wong Chung Chek, Jafri Malin Abdullah, Wong Sii Hieng
Introduction: Degenerative spine disease is increasingly common. There are many spinal fusion techniques used to treat degenerative spine disease. This study aims to compare the functional outcome of open versus minimally invasive surgery (MIS) technique in posterior lumbar instrumentation and fusion in degenerative spine disease and to evaluate the perioperative outcome and complications between MIS and open surgery. Materials and Methods: This is an observational cross-sectional study conducted on all degenerative spine disease patients who underwent both methods of posterior lumbar instrumentation and fusion from 2010 to 2014 by the Orthopedic and Neurosurgery Department, Sarawak General Hospital...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29081940/the-biomechanical-study-of-extraforaminal-lumbar-interbody-fusion-a-three-dimensional-finite-element-analysis
#15
Mingjie Yang, Guixin Sun, Song Guo, Cheng Zeng, Meijun Yan, Yingchao Han, Dongdong Xia, Jingjie Zhang, Xinhua Li, Yang Xiang, Jie Pan, Lijun Li, Jun Tan
OBJECTIVE: Finite-element method was used to evaluate biomechanics stability of extraforaminal lumbar interbody fusion (ELIF) under different internal fixation. METHODS: The L3-L5 level finite-element model was established to simulate decompression and internal fixation at L4-L5 segment. The intact finite model was treated in accordance with the different internal fixation. The treatment groups were exerted 400 N load and 6 N·m additional force from motion to calculate the angular displacement of L4-L5...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29076042/interbody-fusion-techniques-in-the-surgical-management-of-degenerative-lumbar-spondylolisthesis
#16
REVIEW
Peter B Derman, Todd J Albert
PURPOSE OF REVIEW: The various lumbar interbody fusion (IBF) techniques and the evidence for their use in the treatment of degenerative lumbar spondylolisthesis (DLS) are described in this review. RECENT FINDINGS: The existing evidence is mixed regarding the indications for and utility of IBF in DLS, but its use in the setting of pre-operative instability is most strongly supported. Anterior (ALIF), lateral (LLIF), posterior (PLIF), transforaminal (TLIF), and axial (AxiaLIF) lumbar IBF approaches have been described...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29074423/percutaneous-endoscopic-lumbar-reoperation-for-recurrent-sciatica-symptoms-a-retrospective-analysis-of-outcomes-and-prognostic-factors-in-94-patients
#17
Junlong Wu, Chao Zhang, Kang Lu, Changqing Li, Yue Zhou
BACKGROUND: Recurrent sciatica symptoms after the prior surgical intervention is a relatively common and troublesome clinical problem. Percutaneous endoscopic lumbar decompression has been proved an effective method for recurrent lumbar disc herniation. However, the prognostic factors and outcomes of percutaneous endoscopic lumbar reoperation (PELR) for recurrent sciatica symptoms were still unknown. The purpose of this study was to evaluate the outcomes and prognostic factors of patients who underwent PELR for recurrent sciatica symptoms...
October 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29061616/transforaminal-lumbar-interbody-fusion-with-cortical-bone-trajectory-screws-versus-traditional-pedicle-screws-fixation-a-study-protocol-of-randomised-controlled-trial
#18
Zhenhua Feng, Xiaobin Li, Qian Tang, Chenggui Wang, Wenhao Zheng, Hui Zhang, Ai-Min Wu, Naifeng Tian, Yaosen Wu, Wenfei Ni
INTRODUCTION: Transforaminal lumbar interbody fusion (TLIF) has been widely used in the treatment of lumbar degenerative disc disorders and shows favourable clinical results. Recently, cortical bone trajectory (CBT) has become a new trajectory for screw insertion in the lumbar spine. Several biomechanical studies have demonstrated that the CBT technique achieves screw purchase and strength greater than the traditional method. Currently, the available data on the clinical effectiveness of the two performed surgeries, TLIF with CBT screws (CBT-TLIF) and TLIF with traditional pedicle screws (PS-TLIF), are insufficient...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29050895/minimal-invasive-lumbar-spine-revision-surgery-at-distance-from-the-dura-and-postsurgical-scar-tissue-extraforaminal-lumbar-interbody-fusion-elif
#19
Arthur R Kurzbuch, Didier Recoules-Arche
Lumbar spine revision surgery is considered as challenging and related to longer operation time and complications because of the loss of anatomical landmarks and the formation of postoperative epidural fibrosis. Minimal invasive lumbar spinal surgery techniques have been refined over the last 5 years but the reexposure of the dura, the formation of postsurgical scar tissue and related dural tears remain a source of complications. For lumbar spinal revision surgery we advocate the minimal invasive Extraforaminal Lumbar Interbody Fusion (ELIF) technique...
October 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29017312/aortic-injury-during-transforaminal-lumbar-interbody-fusion
#20
Hee Jin Bae, Tack Geun Cho, Chang Hyun Kim, Ho Kook Lee, Jae Gon Moon, Jong Il Choi
Aortic injury during transforaminal lumbar interbody fusion (TLIF) is a rare but severe complication. We experienced aortic injury during TLIF at L3-4 with a 59-year-old woman diagnosed with an adjacent segment disease at L3-4. Severe bleeding occurred during disc space expansion, and the blood pressure dropped to 60/40 mmHg. The patient's vital sign stabilized after compression with gauze and Gelfoam in addition to blood transfusion. The patient was treated with endovascular repair using a percutaneous technique after intertransverse fusion at L3-4 was completed...
September 2017: Korean Journal of Spine
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