Evaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc Disease

Background data: Chronic discogenic back pain caused by degenerative disc disease is a common problem in general population. In clinical practice, lateral recess stenosis and foraminal stenosis may induce nerve root compression which can cause unilateral symptoms. Less invasive spinal fusion is perf...

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Autores principales:	Mahmoud Nafady, Ahmed Elsayed, Hesham El Saghir, Yasser Allam
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2018
Materias:	umbar disc disease unilateral fixation lumbar fusion Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/64ebc973d05c4510915814b6b1ad8d1d
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spelling	oai:doaj.org-article:64ebc973d05c4510915814b6b1ad8d1d2021-12-02T00:13:28ZEvaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc DiseaseDOI:10.21608/ESJ.2018.112392314-89502314-8969https://doaj.org/article/64ebc973d05c4510915814b6b1ad8d1d2018-04-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_11239.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background data: Chronic discogenic back pain caused by degenerative disc disease is a common problem in general population. In clinical practice, lateral recess stenosis and foraminal stenosis may induce nerve root compression which can cause unilateral symptoms. Less invasive spinal fusion is performed by a unilateral approach, which may significantly minimize or diminish the iatrogenic soft tissue injury, the intra-operative blood loss, the postoperative pain and the duration of hospital stays. Purpose: to evaluate the efficacy of PLIF and unilateral pedicle screw fixation in degenerative lumbar disc disease Study Design: A prospective clinical case study. Patient and Methods: This study was carried out on 30 patients (16 males and 14 females) with mean age of 40.35±9.82 years. All failed conservative treatment and had confirmed diagnosis radiologically. All underwent posterior lumbar decompression, interbody fusion with single oblique cage filled with local bone and unilateral pedicle screw fixation. Clinical assessment was done using Visual Analogue Scale (VAS) and ODI. Radiological assessment of fusion was done using BSF criteria. Patients were followed for 17.77±7.17 months postoperatively. Results: According to ODI; 12 patients (40%) had excellent clinical results, 15 (50%) had good results, 3 (10%) had fair results. The mean VAS of leg pain improved from 6.80±1.37 to 2.17±0.91, where the VAS of back pain improved from 5.33±1.18 to 2.13±0.90 postoperative. All sensory and motor deficits cleared apart from 3 patients with mild leg paresthesia. Radiologically, 28 patients (93%) showed successful fusion at the end of the follow up period. Reported complications include, one (3.3%) wound infection, one (3.3) intra-operative dural tear, and two partial (grade 3) foot drop. There were two patients with pseudoarthrosis, although there was no case of implant failure or screw breakage. Conclusion: Our data suggest that conducting PLIF using the diagonal insertion of a single cage with supplemental unilateral transpedicular screw instrumentation enables sufficient decompression and solid interbody fusion. (2017ESJ152)Mahmoud Nafady Ahmed Elsayed Hesham El Saghir Yasser AllamEgyptian Spine Associationarticleumbar disc diseaseunilateral fixationlumbar fusionNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 26, Iss 1, Pp 15-24 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	umbar disc disease unilateral fixation lumbar fusion Neurology. Diseases of the nervous system RC346-429
spellingShingle	umbar disc disease unilateral fixation lumbar fusion Neurology. Diseases of the nervous system RC346-429 Mahmoud Nafady Ahmed Elsayed Hesham El Saghir Yasser Allam Evaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc Disease
description	Background data: Chronic discogenic back pain caused by degenerative disc disease is a common problem in general population. In clinical practice, lateral recess stenosis and foraminal stenosis may induce nerve root compression which can cause unilateral symptoms. Less invasive spinal fusion is performed by a unilateral approach, which may significantly minimize or diminish the iatrogenic soft tissue injury, the intra-operative blood loss, the postoperative pain and the duration of hospital stays. Purpose: to evaluate the efficacy of PLIF and unilateral pedicle screw fixation in degenerative lumbar disc disease Study Design: A prospective clinical case study. Patient and Methods: This study was carried out on 30 patients (16 males and 14 females) with mean age of 40.35±9.82 years. All failed conservative treatment and had confirmed diagnosis radiologically. All underwent posterior lumbar decompression, interbody fusion with single oblique cage filled with local bone and unilateral pedicle screw fixation. Clinical assessment was done using Visual Analogue Scale (VAS) and ODI. Radiological assessment of fusion was done using BSF criteria. Patients were followed for 17.77±7.17 months postoperatively. Results: According to ODI; 12 patients (40%) had excellent clinical results, 15 (50%) had good results, 3 (10%) had fair results. The mean VAS of leg pain improved from 6.80±1.37 to 2.17±0.91, where the VAS of back pain improved from 5.33±1.18 to 2.13±0.90 postoperative. All sensory and motor deficits cleared apart from 3 patients with mild leg paresthesia. Radiologically, 28 patients (93%) showed successful fusion at the end of the follow up period. Reported complications include, one (3.3%) wound infection, one (3.3) intra-operative dural tear, and two partial (grade 3) foot drop. There were two patients with pseudoarthrosis, although there was no case of implant failure or screw breakage. Conclusion: Our data suggest that conducting PLIF using the diagonal insertion of a single cage with supplemental unilateral transpedicular screw instrumentation enables sufficient decompression and solid interbody fusion. (2017ESJ152)
format	article
author	Mahmoud Nafady Ahmed Elsayed Hesham El Saghir Yasser Allam
author_facet	Mahmoud Nafady Ahmed Elsayed Hesham El Saghir Yasser Allam
author_sort	Mahmoud Nafady
title	Evaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc Disease
title_short	Evaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc Disease
title_full	Evaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc Disease
title_fullStr	Evaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc Disease
title_full_unstemmed	Evaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc Disease
title_sort	evaluation of the results of unilateral pedicular fixation and interbody fusion in treatment of degenerative lumbar disc disease
publisher	Egyptian Spine Association
publishDate	2018
url	https://doaj.org/article/64ebc973d05c4510915814b6b1ad8d1d
work_keys_str_mv	AT mahmoudnafady evaluationoftheresultsofunilateralpedicularfixationandinterbodyfusionintreatmentofdegenerativelumbardiscdisease AT ahmedelsayed evaluationoftheresultsofunilateralpedicularfixationandinterbodyfusionintreatmentofdegenerativelumbardiscdisease AT heshamelsaghir evaluationoftheresultsofunilateralpedicularfixationandinterbodyfusionintreatmentofdegenerativelumbardiscdisease AT yasserallam evaluationoftheresultsofunilateralpedicularfixationandinterbodyfusionintreatmentofdegenerativelumbardiscdisease
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Evaluation of the Results of Unilateral Pedicular Fixation and Interbody Fusion in Treatment of Degenerative Lumbar Disc Disease

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