The combined use of unilateral pedicle screw and contralateral facet joint screw fixation in transforaminal lumbar interbody fusion

Cao, Yingping; Chen, Zixian; Jiang, Chun; Wan, Shengcheng; Jiang, Xiaoxing; Zhu, Feng

doi:10.1007/s00586-015-4120-x

Cited by 19 publications

(12 citation statements)

References 19 publications

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“…Researchers have attempted to achieve satisfactory lumbar fusion with MIS techniques while reducing injury and implant costs [42]. The morbidity associated with open TLIF is extensive, and prolonged muscle ischemia occurs as a result of the extensive muscle stripping and retraction that occurs during the surgical approach [43, 44].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive unilateral pedicle screws and a translaminar facet screw fixation and interbody fusion for treatment of single-segment lower lumbar vertebral disease: surgical technique and preliminary clinical results

Huang

Wang

et al. 2017

J Orthop Surg Res

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BackgroundConventional open transforaminal lumbar interbody fusion (TLIF) using unilateral pedicle screws and a translaminar facet screw has been performed for many years with good results. The outcomes of minimally invasive TLIF (MIS TLIF) are similar to the good outcomes of open TLIF, with the additional benefits of reducing iatrogenic injury, shortening hospital stays, and reducing the recovery duration. Instead of using small cuts on both sides, we performed MIS TLIF through a single cut using unilateral pedicle screws and a translaminar facet screw. The operative feasibility, efficacy safety, and benefits of single-level MIS TLIF of such techniques require further clarification.MethodsA total of 60 patients with various single-segment lower lumbar vertebral diseases were treated in our department from January 2010 to March 2013. All the patients were initially performed single-level MIS TLIF using a hybrid construction of unilateral pedicle screws and a translaminar facet screw. Patient demographics and operative data were collected. The clinical outcomes were assessed before surgery and 3, 6, 12, and 24 months after surgery using the visual analog scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Radiologic assessment of the lumbar spine with static and dynamic plain radiographs was performed 3, 6, 12, and 24 months after surgery. The fusion rates were assessed by an independent radiologist 2 years after surgery according to the Bridwell interbody fusion grading system.ResultsNo patients experienced significant postoperative complications. Excepting two cases, 58 cases were followed up for 24–38 months, averaged 29.9 ± 4.1 months. The patients’ average age was 46.6 ± 11.5 years, operative time 109.7 ± 17.8 min, intraoperative blood loss 67.3 ± 29.7 ml, length of incision 29.0 ± 3.2 mm, fluoroscopy time 31.1 ± 7.2 s, time to ambulation 20.3 ± 7.0 h, length of hospital stay 5.1 ± 1.1 days, and length of the translaminar facet screw 51.7 ± 3.4 mm. Screw position results: type I, 54 cases with 54 segments; type II, four cases with four segments. There were two (3.4%) translaminar facet screw failures, which were intraoperatively converted to a bilateral pedicle screw fixation procedure and excluded from the research. The postoperative images showed good positioning of the hybrid internal fixation, and all of the translaminar facet screws penetrated the facet joint. Two (3.6%) translaminar facet screws penetrated the lateral lamina and two (3.6%) translaminar facet screws penetrated the medial lamina without any serious neural complications. During the follow-up, there was no screw loosening or pedicle fracture observed. The VAS and ODI scores were significantly improved compared with the preoperative scores (P < 0.05), and the symptoms disappeared gradually. Fifty-one patients (87.9%) achieved grade I fusion radiographically at the final follow-up.ConclusionsMIS TLIF using a hybrid construction of unilateral pedicle screws and a translaminar facet screw is safe and effective in the trea...

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Section: Discussionmentioning

confidence: 99%

Minimally invasive unilateral pedicle screws and a translaminar facet screw fixation and interbody fusion for treatment of single-segment lower lumbar vertebral disease: surgical technique and preliminary clinical results

Huang

Wang

et al. 2017

J Orthop Surg Res

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“…Given that there is currently considerable heterogeneity in PSF techniques (ie, unilateral vs. bilateral fixation; open vs. minimally invasive access; navigation aided), identification of a pertinent homogenous PSF cohort for direct comparative purposes was challenging. 19,39,[42][43][44] Accordingly, outcomes with ISPF should be considered primarily within the context of what is clinically advantageous (ie, minimal clinically important difference [MCID] values), with direct comparison to PSF outcomes considered secondarily only when appropriate.…”

Section: Introductionmentioning

confidence: 99%

Anterior and Lateral Lumbar Interbody Fusion With Supplemental Interspinous Process Fixation: Outcomes from a Multicenter, Prospective, Randomized, Controlled Study

et al. 2018

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“…The results show that the stability of UPS þ TFS is similar to that of BPS for both 1-level and 2-level lumbar spinal disorders [5][6][7]. Moreover, some recent clinical studies also indicate TLIF using UPS þ TFS by paramedian mini-incision is a safe, feasible and effective method to treat one or two segment lumbar degenerative disorders [8,9]. Our own understanding suggests that to insert the translaminar facet screw via the paramedian miniincision approach is technically demanding and requires rich experience.…”

Section: Introductionmentioning

confidence: 72%

Translaminar facet joint screw insertion with a rapid prototyping guide template: a cadaver study

Cao

Zhang

Liang

et al. 2019

Computer Assisted Surgery

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The combined use of unilateral pedicle screw and contralateral facet joint screw fixation in transforaminal lumbar interbody fusion

Abstract: The clinical efficacy and safety of TLIF with UPS+TFS fixation were comparable to BPS fixation; however, the soft tissue injury and the corresponding operation cost were reduced with unilateral pedicle screw plus translaminar facet screw fixation.

Cited by 19 publications

References 19 publications

Minimally invasive unilateral pedicle screws and a translaminar facet screw fixation and interbody fusion for treatment of single-segment lower lumbar vertebral disease: surgical technique and preliminary clinical results

Minimally invasive unilateral pedicle screws and a translaminar facet screw fixation and interbody fusion for treatment of single-segment lower lumbar vertebral disease: surgical technique and preliminary clinical results

Anterior and Lateral Lumbar Interbody Fusion With Supplemental Interspinous Process Fixation: Outcomes from a Multicenter, Prospective, Randomized, Controlled Study

Translaminar facet joint screw insertion with a rapid prototyping guide template: a cadaver study

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