Clinical outcomes of Short Rod Technique in transforaminal lumbar interbody fusion surgery through Wiltse approach: A case series report

Abstract

Objective We present for the first time a novel entry point of pedicle screws (Short Rod Technique, SRT), which can avoid superior facet violation and has been verified as a safe screw placement method. The objective of this study is to report the clinical outcomes of SRT in transforaminal lumbar interbody fusion (TLIF) surgery through Wiltse approach. Methods We retrospectively analyzed the clinical outcomes of 64 patients who received SRT through Wiltse approach with a minimum of 2 years of follow-ups. Demographics, clinical outcomes and radiological parapmeters were recorded and analyzed. Results Less total postoperative drainage volume before removall (27.88 ± 10.27), shorter days of removal of drainage (1.08 ± 0.27) was observed in SRT through Wiltse approach. In addition, patients felt less wound pain after the surgery, improving their HRQOL. Upper adjacent segment degeneration (ASD) was found in 2 petients at final follow-up, and they also received revision surgery. Both back pain, leg pain and ODI improved after the surgery; however, due to the ASD patients, the mean value of leg pain and ODI were greater at final follow-up than they’re at post-operation. Less change of LL was observed at final follow-up than it at post-operation with significant difference. Compared with increase of SS at post-operation, SS decreased at final follow-up with significant difference of change of SS. PT decreased at post-operation, while it was found to be increased at final follow-up. PI remained constant before and after the surgery with no significant difference of change of PI. Sagittal alignment also tended to be imbalanced with the change of SVA signficantly greater at final follow-up than it at post-operation. In addition, due to the two cases of ASD, the loss of disc hight and change of slippage distance of upper adjacent segment were signficantly greater at final follow-up than they’re at post-operation. More degeneration of intervertebral disc was also observed at final follow-up. Conclusion Application of SRT through Wiltse approach in TLIF surgery has been validated as an effective technique with good clinical outcomes, especially for reducing the blood loss and postoperative wound pain and improving patients’ HRQOL. The present study provides spinal surgeons with a novel method for performing TLIF surgery.