Clinical outcomes and complications associated with pedicle screw fixation—augmented lumbar interbody fusion
- 1 October 2004
- journal article
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery: Spine
- Vol. 1 (3), 261-266
- https://doi.org/10.3171/spi.2004.1.3.0261
Abstract
The authors conducted a prospective study to evaluate the clinical and radiological outcomes and complications associated with uni- and bilateral transforaminal lumbar interbody fusion (TLIF) performed using carbon fiber Brantigan I/F Cages and pedicle screw fixation. Forty-two consecutive patients who had undergone uni- or bilateral TLIF between February 1999 and July 2000 were prospectively evaluated. Clinical outcome was graded using a modified Prolo Scale, the McGill Pain Index Scale, a follow-up questionnaire, and charts. An independent radiologist assessed radiological outcomes. All patients were followed for at least 1 year. Based on Prolo Scale scores, an excellent or good 1-year outcome was achieved in 73% of patients; 90% of patients responded that they would undergo the procedure again. At 1 year, radiographic fusion was demonstrated in 74% and was statistically related to clinical outcome (p < 0.05). There were no deaths or major hardware failures. Complications requiring repeated surgery included one case of cerebrospinal fluid (CSF) leakage and one case in which the hemovac drain was retained. There were four cases involving minor wound infections, eight involving CSF leaks, and none requiring repeated surgery. On routine follow-up radiography one pedicle screw was found to be broken; the patient remained asymptomatic and fusion occurred. Unilateral and bilateral TLIF involving placement of carbon fiber cages and pedicle screw fixation are effective treatment options in patients with indications for lumbar arthrodesis. The procedures result in acceptable rates of fusion and clinical success, and a minimal incidence of morbidity when performed by an experienced surgeon.Keywords
This publication has 19 references indexed in Scilit:
- Radiographic Characteristics on Conventional Radiographs After Posterior Lumbar Interbody Fusion: Comparative Study Between Radiotranslucent and Radiopaque CagesPublished by Ovid Technologies (Wolters Kluwer Health) ,2001
- Posterior lumbar interbody fusion for revision disc surgery: review of 50 cases in which carbon fiber cages were implantedJournal of Neurosurgery: Spine, 2001
- Threaded cortical bone dowels for lumbar interbody fusion: over 1-year mean follow up in 28 patientsJournal of Neurosurgery: Spine, 2001
- Complications of posterior lumbar interbody fusion when using a titanium threaded cage deviceJournal of Neurosurgery: Spine, 2000
- Lumbar Interbody Fusion Using the Brantigan I/F Cage for Posterior Lumbar Interbody Fusion and the Variable Pedicle Screw Placement SystemSpine, 2000
- Posterior lumbar interbody fusion with cages: an independent review of 71 casesJournal of Neurosurgery: Spine, 1999
- Interbody Lumbar Fusion Using a Carbon Fiber Cage Implant Versus Allograft BoneSpine, 1994
- A Carbon Fiber Implant to Aid Interbody Lumbar FusionSpine, 1993
- Correlation of Radiologic Assessment of Lumbar Spine Fusions with Surgical ExplorationSpine, 1991
- Comparison of Disc Space Heights after Anterior Lumbar Interbody FusionSpine, 1989