Application of the Technique of "Mobile Skin and Soft Tissue Window" in Single Segment Lumbar Interbody Fusion
Journal of Surgery
Volume 4, Issue 2, April 2016, Pages: 45-48
Received: Apr. 11, 2016;
Accepted: Apr. 22, 2016;
Published: May 12, 2016
Views 3120 Downloads 96
Jing Wang, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Min Chen, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Jiang Du, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
To investigate the surgical techniques and short-term clinical effects of minimally invasive lumbar interbody fusion in the treatment of lumbar degenerative diseases, 43 patients who underwent minimally invasive posterior lumbar interbody fusion from January 2012 to September 2014 were retrospectively reviewed. The lesion was located by C- arm fluoroscopy during the operation. The working areas for placing pedicle screw, fusion and decompression were well exposed by the technique of "mobile skin and soft tissue window". The operation time, intraoperative blood loss, length of incision, blood drainage and complication after operation were recorded. Oswestry disability index (ODI) and visual analogue scale (VAS) of pre-operation, 7 days, 1, 3 and 12 months postoperatively were evaluated. 37 patients were followed up for an average of 15.2 ± 4.7 months. Intraoperative blood loss was 175.1 ± 71.8 ml; operation time was 129.0 ± 12.0 min; length of incision was 5.4 ± 0.3 cm and postoperative blood drainage was 116.5 ± 66.0 ml. Postoperative lumbar and leg VAS and ODI scores were significantly decreased, comparing with that of pre-operation (P < 0.05). Lumbar VAS score was 6.6 ± 0.8 before operation and 0.7 ± 0.6 at 12-month follow-up. Leg VAS score was 7.0 ± 0.1 before operation and 0.6 ± 0.5 at 12-month follow-up. Average ODI percent was 68.6% ± 5.4% before operation and 6.2% ± 1.6% at 12-month follow-up. There were no internal fixation loose and fracture, and the radiographic findings were consistent with the standard of the lumbar interbody fusion at the last follow-up. In the current study, the minimally invasive treatment concept and the technology of "mobile skin and soft tissue window" are applied to the traditional posterior lumbar interbody fusion surgery. This modified method can not only obtain good vision without special instruments, but can also significantly reduce the skin incision and muscle tissue dissection, get less surgical trauma and better functional recovery, achieving a satisfactory clinical effect for single segment lumbar degenerative disease.
Application of the Technique of "Mobile Skin and Soft Tissue Window" in Single Segment Lumbar Interbody Fusion, Journal of Surgery.
Vol. 4, No. 2,
2016, pp. 45-48.
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Kanemura, T., et al., The maturation of grafted bone after posterior lumbar interbody fusion with an interbody carbon cage: a prospective five-year study. J Bone Joint Surg Br, 2011. 93(12): p. 1638-45.
Kim, D. Y., et al., Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation. Spine (Phila Pa 1976), 2005. 30(1): p. 123-9.
Barnes, B., et al., Threaded cortical bone dowels for lumbar interbody fusion: over 1-year mean follow up in 28 patients. J Neurosurg, 2001. 95(1 Suppl): p. 1-4.
Yoo, J. S., et al., Paraspinal muscle changes of unilateral multilevel minimally invasive transforaminal interbody fusion. J Orthop Surg Res, 2014. 9: p. 130.
Huang, C. J., et al., [Analysis of intermediate and long term clinical effects on discectomy with diskoscope]. Zhongguo Gu Shang, 2009. 22(4): p. 251-3.
Hoogland, T., et al., Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine (Phila Pa 1976), 2006. 31(24): p. E890-7.
Hirano, Y., et al., Percutaneous endoscopic lumbar discectomy - early clinical experience. Neurol Med Chir (Tokyo), 2012. 52(9): p. 625-30.
Kim, C. W., et al., The current state of minimally invasive spine surgery. Instr Course Lect, 2011. 60: p. 353-70.
Erken, H. Y., et al., Can radiation exposure to the surgeon be reduced with freehand pedicle screw fixation technique in pediatric spinal deformity correction? A prospective multicenter study. Spine (Phila Pa 1976), 2014. 39(6): p. 521-5.
Xia, X. L., et al., Mast Quadrant-assisted minimally invasive modified transforaminal lumbar interbody fusion: single incision versus double incision. Chin Med J (Engl), 2015. 128(7): p. 871-6.
McAnany, S. J., et al., Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis. Global Spine J, 2016. 6(2): p. 186-94.
Uribe, J. S., S. L. Myhre, and J. A. Youssef, Preservation or Restoration of Segmental and Regional Spinal Lordosis Using Minimally Invasive Interbody Fusion Techniques in Degenerative Lumbar Conditions: a Literature Review. Spine (Phila Pa 1976), 2016.
Cho, J. Y., S. H. Lee, and H. Y. Lee, Prevention of development of postoperative dysesthesia in transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation: floating retraction technique. Minim Invasive Neurosurg, 2011. 54(5-6): p. 214-8.
Ghahreman, A., et al., Minimal access versus open posterior lumbar interbody fusion in the treatment of spondylolisthesis. Neurosurgery, 2010. 66(2): p. 296-304; discussion 304.
Smith, N., et al., Systematic review of microendoscopic discectomy for lumbar disc herniation. Eur Spine J, 2013. 22(11): p. 2458-65.