Operative Versorgung degenerativer Erkrankungen der Lendenwirbelsäule

Czabanka, Marcus; Thomé, Claudius; Ringel, Florian; Meyer, Bernhard; Eicker, Sven Oliver; Rohde, Veit; Stoffel, Michael; Vajkoczy, Peter

doi:10.1007/s00115-018-0523-3

Cited by 10 publications

(5 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lumbar degenerative diseases, including lumbar degenerative spondylolisthesis, lumbar spinal stenosis, and degenerative scoliosis, involve the pathophysiological process of the natural aging and degeneration of the lumbar intervertebral disc and the paravertebral tissue ( 1 ). These diseases are the main cause of low back pain and leg pain in middle-aged and elderly people and can cause nerve injury in severe cases ( 2 ). With the aging of the global population, the incidence of lumbar degenerative diseases has been gradually increasing ( 3 ), placing a heavy burden on families and society.…”

Section: Introductionmentioning

confidence: 99%

Fusion rate and complications of oblique lumbar interbody fusion and transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a meta-analysis

Xiao,

Duan,

Pan

et al. 2024

Front. Surg.

View full text Add to dashboard Cite

BackgroundThere currently exists some controversy about the efficacy of oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar degenerative diseases.AimThis study compares the application effects of OLIF and TLIF in lumbar degenerative diseases by reviewing the literature and using meta-analysis.MethodsWe included randomized controlled trials and cohort studies comparing TLIF and OLIF in the treatment of lumbar degenerative diseases. We searched for words such as “intervertebral disc degeneration,” “spinal fusion,” and “lumbar vertebrae” in the PubMed, Embase, and Cochrane Library databases. The search date was set from the establishment date of the database to October 2023. Two authors independently conducted document screening, data abstraction, and qualitative assessment. A meta-analysis was performed and adapted to RevMan5.3 software. The odds ratio (OR), weighted mean difference (WMD), and 95% CI were calculated by adopting a fixed-effect model (FEM) or a random-effect model (REM).ResultsA total of 18 cohort studies were included with 1,550 patients, of whom 806 patients underwent TLIF (TLIF group) and 744 patients underwent OLIF (OLIF group). There were no significant differences found in the fusion rate [OR = 1.58 (0.95, 2.64), P = 0.08], complication rate [OR = 1.25 (0.93, 1.68), P = 0.14], and visual analog scale for back pain (VAS-BP) [WMD = 0.00 (−0.13, 0.14), P = 0.96] between the two groups. Compared with the TLIF group, the OLIF group had a lower Oswestry disability index (ODI) [WMD = −0.62 (−1.03, −0.20), P = 0.003], a higher foramen height (FH) [WMD = 2.03 (1.42, 2.46), P < 0.001], a higher disc height (DH) [WMD = 1.69 (1.17, 2.22), P < 0.001], and a shorter length of stay (LOS) [WMD = −1.80 (−2.55, −1.05), P < 0.001].ConclusionIn the treatment of lumbar degenerative diseases, compared with TLIF, OLIF has more advantages in terms of improving the lumbar function, restoring the FH and DH, and shortening the LOS. Both methods have comparable fusion rates, complication rates, and lumbar pain improvements. Due to the small amount of research and unclear assessment of the risk of bias, high-quality, large-sample randomized controlled studies are required to prove it.

show abstract

Section: Introductionmentioning

confidence: 99%

Fusion rate and complications of oblique lumbar interbody fusion and transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a meta-analysis

Xiao,

Duan,

Pan

et al. 2024

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…Back pain resulting from degenerative changes of the spine represents one of the most prevalent medical conditions in the human population ( Heliovaara et al, 1989 ; Schmidt et al, 2007 ; Raspe, 2012 ). In addition to conservative therapeutic approaches, surgical intervention plays a crucial role in the management of specific back pain associated with structural skeletal abnormalities ( Czabanka et al, 2018 ). Among these structural abnormalities, degenerative spondylolisthesis (DS) frequently affects the lumbar spine of elderly patients ( Pietrantonio et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Invasiveness of decompression surgery affects modeled lumbar spine kinetics in patients with degenerative spondylolisthesis

Kosterhon,

Müller,

Rockenfeller

et al. 2024

Front. Bioeng. Biotechnol.

Self Cite

View full text Add to dashboard Cite

Introduction: The surgical treatment of degenerative spondylolisthesis with accompanying spinal stenosis focuses mainly on decompression of the spinal canal with or without additional fusion by means of a dorsal spondylodesis. Currently, one main decision criterion for additional fusion is the presence of instability in flexion and extension X-rays. In cases of mild and stable spondylolisthesis, the optimal treatment remains a subject of ongoing debate. There exist different opinions on whether performing a fusion directly together with decompression has a potential benefit for patients or constitutes overtreatment. As X-ray images do not provide any information about internal biomechanical forces, computer simulation of individual patients might be a tool to gain a set of new decision criteria for those cases.Methods: To evaluate the biomechanical effects resulting from different decompression techniques, we developed a lumbar spine model using forward dynamic-based multibody simulation (FD_MBS). Preoperative CT data of 15 patients with degenerative spondylolisthesis at the level L4/L5 who underwent spinal decompression were identified retrospectively. Based on the segmented vertebrae, 15 individualized models were built. To establish a reference for comparison, we simulated a standardized flexion movement (intact) for each model. Subsequently, we performed virtual unilateral and bilateral interlaminar fenestration (uILF, bILF) and laminectomy (LAM) by removing the respective ligaments in each model. Afterward, the standardized flexion movement was simulated again for each case and decompression method, allowing us to compare the outcomes with the reference. This comprehensive approach enables us to assess the biomechanical implications of different surgical approaches and gain valuable insights into their effects on lumbar spine functionality.Results: Our findings reveal significant changes in the biomechanics of vertebrae and intervertebral discs (IVDs) as a result of different decompression techniques. As the invasiveness of decompression increases, the moment transmitted on the vertebrae significantly rises, following the sequence intact ➝ uILF ➝ bILF ➝ LAM. Conversely, we observed a reduction in anterior–posterior shear forces within the IVDs at the levels L3/L4 and L4/L5 following LAM.Conclusion: Our findings showed that it was feasible to forecast lumbar spine kinematics after three distinct decompression methods, which might be helpful in future clinical applications.

show abstract

“…Research shows that the incidence of low back pain increases with age up to 60 years and decreases after that [ 1 ]. Lumbar disc herniation, lumbar spinal stenosis, spondylolisthesis, and other lumbar degenerative diseases are the main causes of low back pain [ 2 ]. Chronic low back pain caused by lumbar degenerative diseases severely affects the daily life of patients and even causes a huge economic burden on society and individuals.…”

Section: Introductionmentioning

confidence: 99%

“…However, some studies have shown that only approximately half of the patients undergoing conservative treatment have significant improvement in the symptoms of low back pain in the short term, while surgical treatment can not only relieve pain in a short time but also control pain symptoms well within 4 years after surgery [ 4 ]. Chen et al found that surgical treatment has advantages in terms of short-term pain and quality of life compared with conservative treatment [ 5 ], and other scholars believe that early surgical treatment of symptomatic lumbar degenerative diseases is conducive to faster recovery of neurological function [ 2 ]. Traditional surgical approaches include posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of oblique lumbar interbody fusion versus transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a systematic review and meta-analysis

Wang

Shao‐Horn

et al. 2023

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Introduction This meta-analysis aimed to compare the differences in postoperative efficacy between oblique lumbar interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of lumbar degenerative diseases. Materials and methods Strictly based on the search strategy, we searched the published papers on OLIF and TLIF for the treatment of lumbar degenerative diseases in PubMed, Embase, CINAHL, and Cochrane Library. A total of 607 related papers were retrieved, and 15 articles were finally included. The quality of the papers was evaluated according to the Cochrane systematic review methodology, and the data were extracted and meta-analyzed using Review manager 5.4 software. Results Through comparison, it was found that in the treatment of lumbar degenerative diseases, the OLIF group had certain advantages over the TLIF group in terms of intraoperative blood loss, hospital stay, visual analog scale (VAS) for leg pain (VAS-LP), Oswestry disability index (ODI), disc height (DH), foraminal height (FH), fused segmental lordosis (FSL), and cage height, and the differences were statistically significant. The results were similar in terms of surgery time, complications, fusion rate, VAS for back pain (VAS-BP) and various sagittal imaging indicators, and there was no significant difference. Conclusions OLIF and TLIF can relieve low back pain symptoms in the treatment of lumbar degenerative diseases, but OLIF has certain advantages in terms of ODI and VAS-LP. In addition, OLIF has the advantages of minor intraoperative trauma and quick postoperative recovery.

show abstract

Operative Versorgung degenerativer Erkrankungen der Lendenwirbelsäule

Abstract: The treatment of specific lower back pain due to degenerative lumbar pathologies represents an interdisciplinary challenge, requiring both conservative and surgical treatment strategies in a synergistic treatment concept in order to achieve the best results for patients.

Cited by 10 publications

References 52 publications

Fusion rate and complications of oblique lumbar interbody fusion and transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a meta-analysis

Fusion rate and complications of oblique lumbar interbody fusion and transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a meta-analysis

Invasiveness of decompression surgery affects modeled lumbar spine kinetics in patients with degenerative spondylolisthesis

Efficacy of oblique lumbar interbody fusion versus transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a systematic review and meta-analysis

Contact Info

Product

Resources

About