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Mast Quadrant-assisted Minimally Invasive Modified Transforaminal lumbar Interbody fusion： Single Incision Versus Double Incision

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Chinese Medical Journal 2015年第7期128卷 871-876页

作者： Xin-Lei Xia Hong-Li Wang Fei-Zhou Lyu Li-Xun Wang Xiao-Sheng Ma Jian-Yuan Jiang Department of Orthopaedics Huashan Hospital Fudan University Shanghai 200040 China

Background： The concept of minimally invasive techniques is to make every effort to reduce tissue damage. Certainly, reducing skin incision is an important part of these techniques. This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion （TLIF） with a small single posterior median incision. Methods： During the period of March 2011 to March 2012, 34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision （single incision group）. The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group. The perioperative conditions of patients in these two groups were statistically analyzed and compared. The Oswestry Disability Index （ODI） scores, Visual Analog Scale （VAS） scores, and sacrospinalis muscle damage evaluation indicators before operation and 3, 12 months postoperation were compared. Results： A total of 31 and 35 cases in the single incision and double incision groups, respectively, completed at least 12 months of systemic follow-up. The differences in perioperative conditions between the two groups were not statistically significant. The incision length of the single incision group was significantly shorter than that of the double incision group （P 〈 0.01）. The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation. However, these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups （P _〉 0.05）. Conclusions： Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

关键词： lnterbody fusion lumbar lumbar fusion Mast Quadrant Retractor Minimally Invasive Spine Surgery Transforaminal lumbar lnterbody fusion

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Is Dynesys dynamic stabilization system superior to posterior lumbar fusion in the treatment of lumbar degenerative diseases?

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World Journal of Clinical Cases 2020年第22期8卷 5496-5500页

作者： Bao-Gan Peng Chun-Hua Gao Department of Spinal Surgery The Third Medical CenterPeople’s Liberation Army General HospitalBeijing 100039China

Dynesys,a pedicle-based dynamic stabilization system,was introduced to overcome some undesirable complications of fusion procedures.Nevertheless,the theoretical advantages of Dynesys over fusion have not been clearly confirmed.The purpose of this editorial was to compare clinical and radiological outcomes of patients who underwent Dynesys system with those who underwent posterior lumbar fusion according to the existing literature and to see if the application of the Dynesys system is superior to the traditional lumbar fusion surgery.According to published clinical reports,the short-term effects of the Dynesys dynamic stabilization system are similar to that of traditional lumbar fusion surgery.Three comparative studies of Dynesys dynamic stabilization and fusion surgery with medium-term follow-up are encouraging.However,the results from four single-treatment-arm and small-sample studies of case series with long-term follow-up were not encouraging.In the present circumstances,it is not possible to conclude that the Dynesys dynamic stabilization system is superior to fusion surgery for lumbar degenerative diseases.

关键词： Dynamic stabilization system lumbar fusion lumbar degenerative diseases Complication

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Transforaminal lumbar Interbody fusion for Traumatic lumbar Spondylolisthesis

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Journal of Shanghai Jiaotong university(Science) 2010年第5期15卷 626-631页

作者：徐建广曾炳芳孔维清周蔚付一山赵必增张涛连小峰 Spinal Surgery Unit Orthopaedic Departmentthe Sixth People's Hospital Affiliated to Shanghai Jiaotong University

To evaluate the clinical outcome,effectiveness and safety of the surgical management of traumatic lumbar spondylolisthesis with transforaminal lumbar interbody fusion (TLIF) with short segmental instrumentation fixation.A retrospective review of a consecutive series of 24 patients with traumatic lumbar spondylolisthesis treated with TLIF procedure was carried out.Intraoperative spinal cord monitoring was used to confirm the peripheral neural function intact during the reduction of the spondylolisthesis.Preoperative clinical and radiographic evaluation of all cases were originally collected prospectively.Data regarding blood loss,operative time,duration of hospital stay,radiographic fusion,instrumentation failure and clinical result were collected and observed at regular follow-up periods.All patients were engaged in high-energy accidents in the lower back and 16 patients had concomitant injuries.The mean operative time was 124 min,mean blood loss was 350 mL,and mean hospital stay was 6.5 days.There were no complications such as incision infection,cerebrospinal fluide (CSF) leakage and nerve root injury and so on.All patients demonstrated a solid lumbar interbody fusion within 4 months,and no evidence of spondylolisthesis correction loss,instrumentation failure and loosing.They all were completely asymptomatic,with normal neurologic findings,and had resumed their previous level of physical activities on the final follow-up.Meticulous clinical examination and careful imaging assessment could assist an early diagonosis in cases of traumatic lumbar spondylolisthesis.Performing open reduction and the TLIF procedure as soon as possible could restore segmental stability and painless function.The TLIF procedure was a safe,effective technique to treat traumatic lumbar spondylolisthesis.

关键词： trauma spondylolisthesis lumbar fusion transforaminal lumbar interbody fusion (TLIF)

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Risk Factor of Postoperative lumbar Surgical Site Infection: A Literature Review

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Open Journal of Orthopedics 2021年第4期11卷 97-109页

作者： Tark Hung Chang Santosh Kumar Sah Chong Zhang Xiao Tao Wu Southeast University School of Medicine Nanjing China Department of Orthopedic Surgery Zhongda Hospital Southeast University Nanjing China

Nowadays there have been various advanced techniques to overcome disparate types of lumbar degenerative diseases. However, post-operation complications such as Surgical Site Infection (SSI) still give the surgeon with a big challenge. This article is going to study the risk factor that causes the lumbar SSI by reviewing all the articles that can be assessed through PubMed, websites of science and other internet data base. Numerous articles have stated different reported prevalence rates of 0.7% to 16% for surgical site infection. This article will document the most common and significant risk factors for SSI. At last, we suggest that there should be preoperative patient screening and postoperative internal environment maintenance, this will be the best way to reduce postoperative SSI rate or prevent SSI from happening.

关键词： Surgical Site Infection (SSI) Post-Operative lumbar Surgery Risk Factor lumbar fusion Review

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A Retrospective Chart Assessment of Clinical Outcomes after Amniotic Suspension Allograft Is Used during Spinal Arthrodesis Procedures

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Surgical Science 2016年第3期7卷 150-156页

作者： Joseph A. Sclafani Kevin Liang Darcy Mosley Mark Prevost Milestone Research Organization San Diego CA USA Southern Orthopedics and Sports Medicine Associates Jasper AL USA

Study Design: This retrospective, non-randomized study was designed to evaluate one-year clinical outcomes in a cohort of patients treated with an amniotic suspension allograft as an adjunct to lumbar interbody fusion. Methods: A single-center chart review was conducted to collect pre-operative and peri-operative data for patients at or beyond the one year post-operative time point. Results: Patients underwent either anterior (n = 22) or posterior (n = 65) lumbar interbody fusion. There were six reoperations reported: pseudarthrosis repair (n = 1), adjacent level decompression (n = 2), removal of symptomatic instrumentation (n = 3). Overall VAS score improved from 7.8 ± 1.7 to 5.5 ± 2.4 at 1 year post-op (n = 86, p = 0.0001) and overall ODI score improved from 55 ± 16 to 42 ± 19 at 1 year post-op (n = 85, p = 0.0001). Patients that were 59 years old or older at the time of surgery reported greater improvement in VAS score (3.6 ± 2.3 point improvement, n = 31) than patients younger than 59 at the time of surgery (1.7 ± 2.2 point improvement, n = 55, p = 0.0005). There was not a significant difference in outcome measures between groups when the data were stratified based on patient BMI, tobacco use, previous surgery, or a primary indication of pseudarthrosis repair. Conclusions: These results indicate that there is a significant clinical improvement when amniotic suspension allograft is used during interbody fusion. Patient groups with increased risk of non-union (increased age, previous pseudarthrosis, and tobacco users) demonstrated improvement in one year post-op outcome measures. Improved clinical outcome implies a high rate of successful arthrodesis in both high and low risk patient populations.

关键词： lumbar fusion Spine Surgery Stem Cells Clinical Outcome

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