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Fusión intersomática lumbar extraforaminal mínimamente invasiva
OBJECTIVES: The objective of the present study was to determine the indications, surgical technique, results, and complications of minimally invasive extraforaminal lumbar interbody fusion (ELIF). INTRODUCTION: ELIF is characterized as removal of the superior articular process (SAP) to access the in...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5799939/ https://www.ncbi.nlm.nih.gov/pubmed/29430325 http://dx.doi.org/10.4103/sni.sni_280_17 |
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author | Landriel, Federico Hem, Santiago Rasmussen, Jorge Vecchi, Eduardo Yampolsky, Claudio |
author_facet | Landriel, Federico Hem, Santiago Rasmussen, Jorge Vecchi, Eduardo Yampolsky, Claudio |
author_sort | Landriel, Federico |
collection | PubMed |
description | OBJECTIVES: The objective of the present study was to determine the indications, surgical technique, results, and complications of minimally invasive extraforaminal lumbar interbody fusion (ELIF). INTRODUCTION: ELIF is characterized as removal of the superior articular process (SAP) to access the intra-canalicular root and disc through Kambin's triangle. METHODS: A retrospective study was conducted of 40 patients operated upon between 2013 and 2015. Patients with low back pain or root pain due to degenerative disc disease, spondylolisthesis grade 1 and 2, recurrent disc herniation, and recess-foraminal stenosis were included. A visual analogue scale (VAS), the Oswestry index, the Weiner scale and the modified MacNab criteria were used to assess pain, clinical and functional results and patient satisfaction one year after surgery. Complications were documented and rated according to their severity, in four degrees. RESULTS: We operated on 25 women and 15 men of average age 57 years. Of the forty, 47.5% were treated for spondylolisthesis, 25% by recess foraminal stenosis. In total, 54 interbody cages and 188 percutaneous pedicle screws were placed; and the mean duration of surgery was 245 (±25.4) minutes. The mean hospitalization time was 3.5 (±0.49) days. We observed nine Grade 1 and one Grade 2 complication. The mean preoperative ODI score was 51.9 ± 4.96, which improved to 12.2 ± 3.19 at one year (P < 0.0001). The mean VAS low back pain rating improved from 8.81 ± 0.62 to 2.12 ± 0.89 (P < 0.0001). By one year post-operatively, 77.5% of the patients had fusion (Bridwell grade 1 or 2). CONCLUSIONS: ELIF is a safe and effective surgical approach. Satisfactory clinical outcomes, comparable to traditional techniques, can be achieved with facet resection limited to the superior articular process. |
format | Online Article Text |
id | pubmed-5799939 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-57999392018-02-09 Fusión intersomática lumbar extraforaminal mínimamente invasiva Landriel, Federico Hem, Santiago Rasmussen, Jorge Vecchi, Eduardo Yampolsky, Claudio Surg Neurol Int Original Article OBJECTIVES: The objective of the present study was to determine the indications, surgical technique, results, and complications of minimally invasive extraforaminal lumbar interbody fusion (ELIF). INTRODUCTION: ELIF is characterized as removal of the superior articular process (SAP) to access the intra-canalicular root and disc through Kambin's triangle. METHODS: A retrospective study was conducted of 40 patients operated upon between 2013 and 2015. Patients with low back pain or root pain due to degenerative disc disease, spondylolisthesis grade 1 and 2, recurrent disc herniation, and recess-foraminal stenosis were included. A visual analogue scale (VAS), the Oswestry index, the Weiner scale and the modified MacNab criteria were used to assess pain, clinical and functional results and patient satisfaction one year after surgery. Complications were documented and rated according to their severity, in four degrees. RESULTS: We operated on 25 women and 15 men of average age 57 years. Of the forty, 47.5% were treated for spondylolisthesis, 25% by recess foraminal stenosis. In total, 54 interbody cages and 188 percutaneous pedicle screws were placed; and the mean duration of surgery was 245 (±25.4) minutes. The mean hospitalization time was 3.5 (±0.49) days. We observed nine Grade 1 and one Grade 2 complication. The mean preoperative ODI score was 51.9 ± 4.96, which improved to 12.2 ± 3.19 at one year (P < 0.0001). The mean VAS low back pain rating improved from 8.81 ± 0.62 to 2.12 ± 0.89 (P < 0.0001). By one year post-operatively, 77.5% of the patients had fusion (Bridwell grade 1 or 2). CONCLUSIONS: ELIF is a safe and effective surgical approach. Satisfactory clinical outcomes, comparable to traditional techniques, can be achieved with facet resection limited to the superior articular process. Medknow Publications & Media Pvt Ltd 2018-01-22 /pmc/articles/PMC5799939/ /pubmed/29430325 http://dx.doi.org/10.4103/sni.sni_280_17 Text en Copyright: © 2018 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Landriel, Federico Hem, Santiago Rasmussen, Jorge Vecchi, Eduardo Yampolsky, Claudio Fusión intersomática lumbar extraforaminal mínimamente invasiva |
title | Fusión intersomática lumbar extraforaminal mínimamente invasiva |
title_full | Fusión intersomática lumbar extraforaminal mínimamente invasiva |
title_fullStr | Fusión intersomática lumbar extraforaminal mínimamente invasiva |
title_full_unstemmed | Fusión intersomática lumbar extraforaminal mínimamente invasiva |
title_short | Fusión intersomática lumbar extraforaminal mínimamente invasiva |
title_sort | fusión intersomática lumbar extraforaminal mínimamente invasiva |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5799939/ https://www.ncbi.nlm.nih.gov/pubmed/29430325 http://dx.doi.org/10.4103/sni.sni_280_17 |
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