Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5711573 | Revista Española de Cirugía Ortopédica y Traumatología | 2017 | 11 Pages |
Abstract
«Minimally invasive» techniques have been recently been developed in order to achieve good clinical results with a low incidence of complications. The extralateral interbody fusion or direct transpsoas is a minimally invasive anterior arthrodesis. A total of 97 patients with 138 segments received surgery between May 2012 and May 2015. The follow-up was from 12-44 months. The mean age was 68 years (41-86). The most common cause of intervention was the adjacent segment (30%), deformity (22%), and lumbar disc disease (21%). The interbody cage was implanted as: Single (stand-alone) in 33%, and additional fixation was used in the others: Screws, percutaneous unilateral (11%), bilateral (27%), or with a lateral plate (62%). The mean stay was 3.2 days (2-6). The score on a lumbar visual analogue scale decreased from 9 to 4.1, and dropped to 3 after one year. The improvement in disc height was from 8.4 mm to 13.8 mm, and a larger increase in the foramen diameter from 10.5 to 13.1 mm, which were statistically significant. The early major complications recorded were, three motor femoral nerve injuries and retroperitoneal haematoma (4%), and the early minor were: two fractures (2%). As major late complications there was an abdominal hernia, a mobilization of 10 mm and three radiculopathy (5%), and as minor late, three fracture, two mobilisations greater than 10 mm, four mobilisations of less than 10 mm, and one mobilisation of a screw plate (10%). The extralateral interbody fusion technique is a safe and reliable when performing a lumbar fusion by an alternative minimally invasive route.
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Authors
I. DomÃnguez, R. Luque, M. Noriega, J. Rey, J. Alia, F. Marco-MartÃnez,