Warning: mkdir(): Permission denied in /home/virtual/lib/view_data.php on line 87 Warning: chmod() expects exactly 2 parameters, 3 given in /home/virtual/lib/view_data.php on line 88 Warning: fopen(/home/virtual/e-kjs/journal/upload/ip_log/ip_log_2024-10.txt): failed to open stream: No such file or directory in /home/virtual/lib/view_data.php on line 95 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 96 Clinical Outcome of Two-Level Percutaneous Pedicle Screw Fixation in Lumbar Degenerative Disease: A Preliminary Report.
Korean J Spine Search

CLOSE


17
Clinical Outcome of Two-Level Percutaneous Pedicle Screw Fixation in Lumbar Degenerative Disease: A Preliminary Report.
Ji Hoon Lee, Sang Gu Lee, Chan Woo Park, Woo Kyung Kim
Department of Neurosurgery, Gachon University of Medical & Science, Gil Medical Center, Incheon, Korea. samddal@gilhospital.com
Abstract
OBJECTIVE
The evolution of minimally invasive techniques should reduce or minimize the destructive aspects of the open techniques but preserve the operative goals of neural decompression and spine fusion. The purpose of this study was to report the clinical experiences for percutaneous posterior fixation of the lumbar spine.
METHODS
A total of 24 patients with two-level lumbar degenerative disease underwent neural decompression, discectomy, and interbody cage insertion via small midline incision with percutaneous pedicle screw fixation. Clinical outcome was measured by Odom's criteria, Visual Analogue Scale (VAS), and Oswestry Disability Index (ODI). Operative results were assessed by total operating time, intraoperative blood loss volume, change of total lumbar lordotic angle (TLA) and segmental lordotic angle (SLA), accuracy of pedicle screws, and rate of bone fusion.
RESULTS
"Excellent" or "good" clinical results were obtained in 19 patients (79.2%). VAS scores prior to surgery to alleviate back and leg pain were 6.67 and 7.17 and 4.75 and 5.00 immediately postoperative and 3.83 and 3.63 at the last follow-up visit, respectively. Preoperative ODI was 66.08%. ODI was 51.83% immediately postoperative and 35.54% at the last follow-up visit. The total procedure required a mean of 4.17 hours. Estimated blood loss was 521ml, and transfusion was needed in 4 patients during the surgery. There was no statistical significance in the change of TLA and SLA for the preoperative, postoperative, and follow-up period, and the bone fusion rate was 91.6%. Of the 144 screws placed, 6 (4%) screws were malpositioned, and two cases involved performing a conventional, open procedure in the earlier stage, since it was difficult to insert screws, due to their pedicle alignment.
CONCLUSION
Two-level percutaneous pedicle screw fixation can be safely and effectively performed using minimally invasive techniques, thereby reducing pain, operating time, and blood loss. Pedicle alignment is a critical factor in multilevel percutaneous pedicle screw fixation.
Keywords: Spinal fusion;Minimally invasive spine surgery;Pedicle screw
  • GS_Medical
  • TOOLS
    • PDF Links PDF Links
    • Full text via DOI   Full text via DOI
    • Download Citation Download Citation
    Share :
    Facebook Twitter Linked In Google+
    METRICS Graph View
    • 3,398 View
    • 31 Download
    Journal Impact Factor 3.8
    SURGERY: Q1
    CLINICAL NEUROLOGY: Q1
    Related articles in NS

    Follow-up Comparison Study of Single-level Posterior Dynamic Stabilization in Lumbar Degenerative Disease 'Interspinous U'vs. 'DIAM'.2008 September;5(3)

    Clinical Experience with Solis™ Cage for Anterior Cervical Interbody Fusion in Degenerative Cervical Diseases: A Preliminary Report2004 June;1(2)

    Radiologic Adjacent Segment Degeneration: Two Levels fusion (L3-4-5 and L4-5-S1) Using Percutaneous Pedicle Screw Fixation in Degenerative Lumbar Spinal Disease; A Preliminary Report.2011 September;8(3)

    Instrumented Fusion of Same-Level Lamina and Transverse Process for the Treatment of Lumbar Spondylolysis: A Preliminary Report.2010 March;7(1)

    Clinical and Radiological Outcome of an Interspinous Dynamic Stabilization System in Degenerative Lumbar Disease:24 Cases with Over 24 Months of Follow-up.2009 September;6(3)



    Editorial Office
    Department of Neurosurgery, CHA Bundang Medical Center,
    CHA University School of Medicine,
    59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea
    Tel: +82-31-780-1924  Fax: +82-31-780-5269  E-mail: support@e-neurospine.org
    The Korean Spinal Neurosurgery Society
    #407, Dong-A Villate 2 Town, 350 Seocho-daero, Seocho-gu, Seoul 06631, Korea
    Tel: +82-2-585-5455  Fax: +82-2-2-523-6812  E-mail: ksns1987@gmail.com
    Business License No.: 209-82-62443

    Copyright © The Korean Spinal Neurosurgery Society.

    Developed in M2PI

    Zoom in Close layer