Percutaneous pedicle screw ifxation combined with minimally invasive lumbar interbody fusion in the treatment of lumbar degenerative disease
HE Er-xing
GUO Jing
CUI Ji-hao
GUO Zhi-yong
YIN Zhi-xun
LI Chuang
TANG Cheng
HE Yi-qian
LIU Cheng-wei
Abstract：Objective To investigate the safety and effectiveness of percutaneous pedicle screw fixation combined with minimally invasive lumbar interbody fusion in the treatment of lumbar degenerative disease.Methods From November 2012 to August 2014, a total of 127 patients with lumbar degeneration and instability were recruited. There were 86 males and 41 females, with the mean age of 58.4 years ( range: 18-79 years ). There were 16 cases of spondylolisthesis, 35 cases of lumbar disc herniation, and 76 cases of lumbar stenosis. According to different pathological characteristics, percutaneous pedicle screw ifxation combined with minimally invasive posterior lumbar interbody fusion ( mini-plif ) (44 cases), minimally invasive transforaminal lumbar interbody fusion ( mini-tlif ) ( 49 cases ) or extended decompression and fusion ( 34 cases ) were performed respectively for treatment. The postoperative followed-up was at least 3 months. Before surgery, all patients received anteroposterior, lateral and lfexion-extension X-ray examination of the lumbar spine, as well as lumbar MRI. The average insertion time and X-ray exposure times for each pedicle screw, average blood loss and postoperative drainage volume for each decompression level were analyzed. Hospital stay, pedicle screw position and complications were also recorded. Pre- and postoperative 3-days, 2-weeks, 3-months visual analogue scale ( VAS ) and Oswestry disability index ( ODI ) scores were compared. Results The average insertion time for each pedicle screw was ( 12.6±6.3 ) min. The average X-ray exposure times for each pedicle screw was ( 4.2±2.3 ) times. The mean blood loss for each decompression level was ( 67.9±16.7 ) ml,and the postoperative drainage volume was ( 52.6±13.8 ) ml. The average hospital stay was ( 9.0±2.4 ) days. The VAS and ODI scores were found to be signiifcantly improved after surgery in 3 groups (P<0.05 ). A total of 635 screws were inserted. The position of pedicle screws was good in 546 screws ( 86.0% ), acceptable in 71 screws ( 11.2% ), and malpositioned in 18 screws ( 2.8% ). Neurological injury occurred in 6 cases ( 4.7% ), and no cerebrospinal lfuid leakage, postoperative hematoma, wound infection and other complications were noted.Conclusions Percutaneous pedicle screw fixation combined with minimally invasive lumbar interbody fusion is a safe, effective and feasible technique for minimally invasive spine surgery, and could be recommended for clinical use.
Keywords：Spinal diseasesSpinal fusionLumbar vertebraeSurgical proceduresminimally invasiveInternal ifxators
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 632-638 )