Facet joint fixation and ALIF, DLIF, or TLIF for treatment of degenerative lumbar disc diseases: retrospective cohort study of a new minimally invasive technique.

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Facet joint fixation and ALIF, DLIF, or TLIF for treatment of degenerative lumbar disc diseases: retrospective cohort study of a new minimally invasive technique.

World Neurosurg. 2018 Mar 24;:

Authors: Belykh E, Kalinin AA, Martirosyan NL, Kerimbayev T, Theodore N, Preul MC, Byvaltsev VA

Abstract
BACKGROUND: Anterior, direct lateral and transforaminal lumbar interbody fusions (ALIF, DLIF, and TLIF) are usually combined with posterior fixation to treat degenerative spinal diseases. Outcomes of ALIF, TLIF, or DLIF combined with a new wedge-shaped, interfacet cage-plate have not been reported. We assessed early clinical outcomes of patients treated with interbody fusion and facet fixation using a titanium wedge-shaped cage-plate.
METHODS: This retrospective observational cohort study included patients (n=80) who underwent 1-level interbody fusion and facet joint fixation via ALIF (n=24) or DLIF (n=26) with bilateral facet fixation or TLIF with ipsilateral pedicle screws and contralateral facet fixation (n=30). Duration of surgery, blood loss, pain (VAS), Oswestry Disability Index (ODI) scores, and Macnab score were assessed up to 12 months postsurgery.
RESULTS: All patients had a significant decrease in pain scores (p<0.01) and an increase in ODI scores (p<0.01), without significant difference between treatment groups. Most surgical outcomes were "excellent" or "good" (n=75, 93.8%) with 5 (6.2%) patients having "satisfactory" outcomes. Within 2 months, all patients returned to their previous work (66, 82.5%) or lighter work (14, 17.5%). Two patients had fusion failure requiring reoperation.
CONCLUSION: Facet fixation with the wedge-shaped cage-plate was associated with minimal soft tissue damage and a low level of postoperative pain. ALIF, DLIF, and TLIF combined with this technique showed good early postoperative clinical and radiologic outcomes. Further studies are needed to assess long-term results and compare them with other fusion methods.

PMID: 29588241 [PubMed - as supplied by publisher]

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