Short-Term Results of Transforaminal Lumbar Interbody Fusion Using Pedicle Screw with Cortical Bone Trajectory Compared with Conventional Trajectory

Yuji Kasukawa; Naohisa Miyakoshi; Michio Hongo; Yoshinori Ishikawa; Daisuke Kudo; Yoichi Shimada

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자료유형: 학술저널

저자정보: Yuji Kasukawa (Akita University Graduate School of Medicine) Naohisa Miyakoshi (Akita University Graduate School of Medicine) Michio Hongo (Akita University Graduate School of Medicine) Yoshinori Ishikawa (Akita University Graduate School of Medicine) Daisuke Kudo (Akita University Graduate School of Medicine) Yoichi Shimada (Akita University Graduate School of Medicine)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.9 No.3

발행연도: 2015.1

수록면: 440 - 448 (9page)

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Study Design: Case-control study. Purpose: To evaluate clinical and radiological results of transforaminal lumbar interbody fusion (TLIF) performed with cortical bone trajectory (CBT) pedicle screw insertion with those of TLIF using ‘conventional’ or percutaneous pedicle screw insertion. Overview of Literature: CBT is a new trajectory for pedicle screw insertion in the lumbar spine; clinical and radiological results of TLIF using pedicle screws inserted with CBT are unclear. Methods: In total, 26 patients (11 males, 15 females) were enrolled in this retrospective study and divided into three groups: TLIF with pedicle screw insertion by conventional minimally invasive methods via the Wiltse approach (M-TLIF, n=10), TLIF with percutaneous pedicle screw insertion (P-TLIF, n=6), and TLIF with pedicle screw insertion with CBT (CBT-TLIF, n=10). Surgical results and preand postoperative radiological findings were evaluated and compared. Results: Intraoperative blood loss was significantly less with CBT-TLIF (p =0.03) than with M-TLIF. Postoperative lordotic angles did not differ significantly among the three groups. Complete fusions were obtained in 10 of 12 levels (83%) with M-TLIF, in seven levels (100%) with P-TLIF, and in 10 of 11 levels (91%) with CBT-TLIF. On postoperative computed tomography, correct positioning was seen in 84.1% of M-TLIF screws, 88.5% of P-TLIF screws, and 90% of CBT-TLIF screws. Conclusions: CBT-TLIF resulted in less blood loss and a shorter operative duration than M-TLIF or P-TLIF. Postoperative rates of bone union, maintenance of lordotic angles, and accuracy of pedicle screw positions were similar among the three groups.

참고문헌 (1)

참고문헌 신청

Schwender JD / 2005 / Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results / J Spinal Disord Tech 18(Suppl):S1~S6

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