Side Fixation Mixed with Lumbar Interbody Fusion: Comparative Evaluation of Scientific Expertise and A New Methodology of Surgical Remedy of Sufferers with Lumbar Degenerative Ailments.

Disc Degeneration

Side Fixation Mixed with Lumbar Interbody Fusion: Comparative Evaluation of Scientific Expertise and A New Methodology of Surgical Remedy of Sufferers with Lumbar Degenerative Ailments.

Vestn Ross Akad Med Nauk. 2016;71(5):375-84

Authors: Byvaltsev VA, Kalinin AA, Okoneshnikova AK, Kerimbaev TT, Belykh EG

Summary
Background: For the therapy of sufferers with degenerative illnesses of the lumbar backbone the strategy of pedicle fixation is widespread, when after open decompression channel construction locking screws are launched into the vertebral physique by way of the again vertebra legs. We first used a essentially new method of fixing the rear utilizing the facet-boards Cage «Side Wedge», when posterior fixation is completed by closing the side joints with minimally invasive, percutaneous methodology. We now have not discovered information on the scientific efficacy of side fixation in scientific literature.
Goals: To check the scientific efficacy of side fixation mixed with interbody fusion within the therapy of sufferers with degenerative lumbar backbone illness.
Supplies and Strategies: The examine included 145 sufferers who had been divided into 2 teams. The examine group with long-term commentary included sufferers (n=100) who underwent a brand new methodology for lumbar fixation; the strategy includes unilateral or bilateral implantation of titanium Cage «side Wedge» within the joint area side joint together with the anterior, lateral, and transforaminal interbody fusion. Scientific comparability group (n=45) included retrospectively recruited sufferers who had been carried out titanium pedicle screw set up after open decompression and interbody fusion posterior lumbar fixation. Dynamic commentary and complete analysis of the therapy scientific outcomes was carried out for 18 months after surgical procedure.
Outcomes: Cage side set up know-how is sort of easy, common for the stabilization of the rear of the advanced after interbody fusion from the entrance, aspect, and rear entry; and doesn’t require the intraoperative utility of high-priced high-tech gear. Comparative evaluation of the principle group confirmed considerably higher outcomes by way of the length of the operation [CG 125 (90; 140) min, the CCG 205 (160; 220) min; p=0.01], the amount of blood loss [CG 80 (70; 120) ml, CCG 350 (300; 550) ml; p=0.008], activation time [CG 2 (1; 2) days, 4 CCG (3; 5) days; p=0.02], size of hospitalization [CG 9 (10; 11) days, the CCG 13 (12; 15) days; p=0.03], the extent of ache on a visible analog scale [CG 3 (2; 4) mm, CCG 15 (12; 18) mm; p=0.001], high quality of life (by index Oswestry) [CG 8 (6; 8) points, the CCG 23 (20; 28) points, p=0.003], and labor rehabilitation [CG 3 (2; 6) months, CCG 9 (6; 12) months; p=0.0001]. The variety of postoperative issues in group 1 was 13%, within the 2nd ? 31,1% (p=zero,0012). The brand new methodology entails fixing the again with significantly much less surgical trauma of paravertebral delicate tissue that leads to early activation of sufferers, discount of keep in hospital interval, and higher practical restoration of sufferers.
Conclusions: The appliance of side fixation mixed with interbody fusion within the therapy of sufferers with degenerative illnesses of the lumbar backbone permits reaching the perfect scientific outcomes and fewer postoperative issues throughout the quick and long-term follow-up if in contrast with the normal methodology of transpedicular stabilization. The mix of low-impact and reliability side fixation strategies for posterior stabilization of the operated section creates favorable situations for the restoration of a practical situation of sufferers, full social and bodily rehabilitation.

PMID: 29297667 [PubMed – indexed for MEDLINE]

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