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Surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation

OBJECTIVES: Lumbosacral fusion through either an anterior or a posterior approach to achieve good lordosis and stability is always a challenging surgical operation and is often accompanied by a higher rate of pseudarthrosis than when other lumbar segments are involved. This study evaluated the clini...

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Autores principales: Huang, Chien-Yuan, Yeh, Kuang-Ting, Yu, Tzai-Chiu, Lee, Ru-Ping, Chen, Ing-Ho, Peng, Cheng-Huan, Liu, Kuan-Lin, Wang, Jen-Hung, Wu, Wen-Tien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5883832/
https://www.ncbi.nlm.nih.gov/pubmed/29643712
http://dx.doi.org/10.4103/tcmj.tcmj_186_17
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author Huang, Chien-Yuan
Yeh, Kuang-Ting
Yu, Tzai-Chiu
Lee, Ru-Ping
Chen, Ing-Ho
Peng, Cheng-Huan
Liu, Kuan-Lin
Wang, Jen-Hung
Wu, Wen-Tien
author_facet Huang, Chien-Yuan
Yeh, Kuang-Ting
Yu, Tzai-Chiu
Lee, Ru-Ping
Chen, Ing-Ho
Peng, Cheng-Huan
Liu, Kuan-Lin
Wang, Jen-Hung
Wu, Wen-Tien
author_sort Huang, Chien-Yuan
collection PubMed
description OBJECTIVES: Lumbosacral fusion through either an anterior or a posterior approach to achieve good lordosis and stability is always a challenging surgical operation and is often accompanied by a higher rate of pseudarthrosis than when other lumbar segments are involved. This study evaluated the clinical and radiological results of lumbosacral fusions achieved through a combined anterior and posterior approach. MATERIALS AND METHODS: From June 2008 to 2012, 20 patients who had L5–S1 instability and stenosis were consecutively treated, first by anterior interbody fusion using an allogenous strut bone graft through the pararectus approach and then by posterior pedicle screw fixation. A minimum of 1-year of clinical and radiological follow-up was conducted. Intraoperative blood loss, surgical time, and any surgery-related complications were recorded. Clinical outcomes were assessed using a visual analog scale (VAS) and the patient's Oswestry Disability Index (ODI) score. After 1 year, radiological outcomes were assessed by analyzing pelvic incidence, lumbar lordosis, and segmental lordosis using static plain films, while fusion stability was assessed using dynamic plain films. RESULTS: The mean operative time and blood loss were 215 min and 325 cc, respectively. After 1 year, the VAS and ODI scores had significantly improved, and stable fusion with good lordotic curvature was obtained in all cases. CONCLUSION: The surgical results of the combined procedure are satisfactory in terms of the functional and radiological outcomes. Our method offers advantages regarding both anterior fusion and posterior fixation.
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spelling pubmed-58838322018-04-11 Surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation Huang, Chien-Yuan Yeh, Kuang-Ting Yu, Tzai-Chiu Lee, Ru-Ping Chen, Ing-Ho Peng, Cheng-Huan Liu, Kuan-Lin Wang, Jen-Hung Wu, Wen-Tien Tzu Chi Med J Original Article OBJECTIVES: Lumbosacral fusion through either an anterior or a posterior approach to achieve good lordosis and stability is always a challenging surgical operation and is often accompanied by a higher rate of pseudarthrosis than when other lumbar segments are involved. This study evaluated the clinical and radiological results of lumbosacral fusions achieved through a combined anterior and posterior approach. MATERIALS AND METHODS: From June 2008 to 2012, 20 patients who had L5–S1 instability and stenosis were consecutively treated, first by anterior interbody fusion using an allogenous strut bone graft through the pararectus approach and then by posterior pedicle screw fixation. A minimum of 1-year of clinical and radiological follow-up was conducted. Intraoperative blood loss, surgical time, and any surgery-related complications were recorded. Clinical outcomes were assessed using a visual analog scale (VAS) and the patient's Oswestry Disability Index (ODI) score. After 1 year, radiological outcomes were assessed by analyzing pelvic incidence, lumbar lordosis, and segmental lordosis using static plain films, while fusion stability was assessed using dynamic plain films. RESULTS: The mean operative time and blood loss were 215 min and 325 cc, respectively. After 1 year, the VAS and ODI scores had significantly improved, and stable fusion with good lordotic curvature was obtained in all cases. CONCLUSION: The surgical results of the combined procedure are satisfactory in terms of the functional and radiological outcomes. Our method offers advantages regarding both anterior fusion and posterior fixation. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5883832/ /pubmed/29643712 http://dx.doi.org/10.4103/tcmj.tcmj_186_17 Text en Copyright: © 2018 Tzu Chi Medical Journal http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Huang, Chien-Yuan
Yeh, Kuang-Ting
Yu, Tzai-Chiu
Lee, Ru-Ping
Chen, Ing-Ho
Peng, Cheng-Huan
Liu, Kuan-Lin
Wang, Jen-Hung
Wu, Wen-Tien
Surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation
title Surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation
title_full Surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation
title_fullStr Surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation
title_full_unstemmed Surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation
title_short Surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation
title_sort surgical results of a one-stage combined anterior lumbosacral fusion and posterior percutaneous pedicle screw fixation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5883832/
https://www.ncbi.nlm.nih.gov/pubmed/29643712
http://dx.doi.org/10.4103/tcmj.tcmj_186_17
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