Functional and radiological comparison of transforaminal lumbar interbody fusion method with interbody fusion device versus stand-alone bone graft in lumbar canal stenosis or degenerative lumbar instability
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20210195Keywords:
Vertebral translation, Radiological, LumbarAbstract
Background: Spinal stability is the vertebral ability to maintain their relationship and limit their relative displacements during physiologic postures and loads.
Methods: Hospital based prospective randomized comparative study design between 2 groups included patients of both sex attending SMS hospital Jaipur, from April 2018 to June 2019 or till sample size was achieved, with due permission from institutional ethical committee and review board and after taking written informed consent from patients.
Results: Inter group comparison of VAS score showed same results in both groups which showed statistically non-significant results. VAS score showed significantly reduction in both group A and B till the study period. Inter group comparison of ODI score showed same results in both groups which showed statistically non-significant results. ODI score showed significantly reduction in both group A and B till the study period. Inter group comparison of fusion rate score showed same results in both groups which showed statistically non-significant results. Fusion rate score showed significantly increased in both group A and B till the study period and at the 12 month it was 100% fusion rate.
Conclusions: In the current series, the TLIF procedure with local bone graft alone improved anterior vertebral translation, disc height, and lumbar lordosis. A proper surgical technique with adequate discectomy and facetectomy would contribute greatly to the improvement of the radiological parameters; however, this improvement was not maintained at the latest follow up.
References
Guillot M, Fournier J, Scheye T, Escande G, Chazal J, Tanguy A et al. Mechanics of the characteristic geometry of the human spine undergoing vertical pressure. Bull Assoc Anat (Nancy). 1990;74:78.
Alqarni AM, Schneiders AG, Hendrick PA. Clinical tests to diagnose lumbar segmental instability: A systematic review. J Orthop Sports Phys Ther. 2011;41:13040.
Posner I, White AA 3rd, Edwards WT, Hayes WC. A biomechanical analysis of the clinical stability of the lumbar and lumbosacral spine. Spine (Phila Pa 1976).1982;7:37489.
Fritz JM, Erhard RE, Hagen BF. Segmental instability of the lumbar spine. Phys Ther. 1998;78:88996.
Kim KT, Suk KS, Kim JM. Future development of interbody fusion cages. J Korean Soc Spine Surg. 2001;8:386491
Hitchon PW, Goel V, Rogge T, Dooris A, Drake J, Torner J et al. Spinal stability with anterior or posterior ray threaded fusion cages. J Neurosurg. 2000;93:1028.
Gologorsky Y, Skovrlj B, Steinberger J, Moore M, Arginteanu M, Moore F et al. Increased incidence of pseudarthrosis after unilateral instrumented transforaminal lumbar interbody fusion in patients with lumbar spondylosis: Clinical article. J Neurosurg Spine. 2014;21:6017.
Giannoudis PV, Dinopoulos H, Tsiridis E. Bone substitutes: an update. Injury. 2005; 36(3):S20-27.
Carragee EJ, Chu G, Rohatgi R, Hurwitz EL, Weiner BK, Yoon ST et al. Cancer risk after use of recombinant bone morphogenetic protein-2 for spinal arthrodesis. J Bone Joint Surg Am. 2013;95(17):1537-45.
Miura Y, Imagama S, Yoda M, Mitsuguchi H, Kachi H. Is local bone viable as a source of bone graft in posterior lumbar interbody fusion? Spine (Phila Pa 1976). 2003;28:2386-9.
Hashimoto T, Shigenobu K, Kanayama M. Clinical results of single-level posterior lumbar interbody fusion using the Brantigan I/F carbon cage filled with a mixture of local morselized bone and bioactive ceramic granules. Spine (Phila Pa 1976). 2002;27:258-62.