PMID- 17415155
OWN - NLM
STAT- MEDLINE
DCOM- 20070423
LR  - 20220331
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 60
IP  - 4 Suppl 2
DP  - 2007 Apr
TI  - Percutaneous transforaminal lumbar interbody fusion for the treatment of 
      degenerative lumbar instability.
PG  - 203-12; discussion 212-3
AB  - OBJECTIVE: Percutaneous spinal instrumentation techniques may be helpful to 
      reduce approach-related morbidity inherent to conventional open surgery. This 
      article reports technique, clinical outcomes, and fusion rates of percutaneous 
      transforaminal lumbar interbody fixation (pTLIF). Results are compared with those 
      of mini-open transforaminal lumbar interbody fixation (oTLIF) using a muscle 
      splitting (Wiltse) approach. METHODS: pTLIF was performed in 43 patients with 
      single-level and 10 patients with bi- or multilevel lumbar discopathy or 
      degenerative pseudolisthesis resulting in axial back pain and claudication, 
      pseudoradicular, or radicular symptoms. Decompression, discectomy, and interbody 
      cage insertion were performed through 18-mm tubular retractors followed by 
      percutaneous pedicle screw-rod fixation. Clinical outcome was assessed by early 
      postoperative pain scores (visual analog score) and standardized functional 
      outcome questionnaires (American Academy of Orthopedic Surgeons lumbar spine and 
      Roland-Morris low back pain score). Fusion rates were assessed by thin-slice 
      computed tomographic scan at 16 months. Clinical outcome, time in the operating 
      room, intraoperative blood loss, and postoperative access-site pain were compared 
      with an institutional reference series of 67 oTLIF procedures. RESULTS: Excellent 
      and good clinical results were obtained in 46 (87%) out of 53 patients at 16 
      months. The time spent in the operating room was equivalent and the blood loss 
      reduced compared with oTLIF (P < 0.01). There was no morbidity related to 
      instrumentation. Postoperative pain was significantly lower after pTLIF after the 
      second postoperative day (P < 0.01). The overall clinical outcome was not 
      different from oTLIF at 8 and 16 months. CONCLUSION: pTLIF allows for safe and 
      efficient minimally invasive treatment of single and multilevel degenerative 
      lumbar instability with good clinical results. Further prospective studies 
      investigating long-term functional results are required to assess the definitive 
      merits of percutaneous instrumentation of the lumbar spine.
FAU - Scheufler, Kai-Michael
AU  - Scheufler KM
AD  - Department of Neurosurgery, University Medical Center Freiburg, Freiburg, 
      Germany. Kai.Scheufler@hirslanden.ch
FAU - Dohmen, Hildegard
AU  - Dohmen H
FAU - Vougioukas, Vassilios I
AU  - Vougioukas VI
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
CIN - Neurosurgery. 2008 Jun;62(6):E1384; author reply E1384. PMID: 18824969
MH  - Aged
MH  - Cohort Studies
MH  - Decompression, Surgical/adverse effects/methods/statistics & numerical data
MH  - Diskectomy, Percutaneous/adverse effects/methods/statistics & numerical data
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae/*surgery
MH  - Male
MH  - Middle Aged
MH  - *Minimally Invasive Surgical Procedures/adverse effects/methods/statistics & 
      numerical data
MH  - Pain Measurement
MH  - Prostheses and Implants
MH  - Retrospective Studies
MH  - Spinal Diseases/diagnostic imaging/*surgery
MH  - *Spinal Fusion/adverse effects/methods/statistics & numerical data
MH  - Surveys and Questionnaires
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
EDAT- 2007/04/07 09:00
MHDA- 2007/04/24 09:00
CRDT- 2007/04/07 09:00
PHST- 2007/04/07 09:00 [pubmed]
PHST- 2007/04/24 09:00 [medline]
PHST- 2007/04/07 09:00 [entrez]
AID - 00006123-200704001-00002 [pii]
AID - 10.1227/01.NEU.0000255388.03088.B7 [doi]
PST - ppublish
SO  - Neurosurgery. 2007 Apr;60(4 Suppl 2):203-12; discussion 212-3. doi: 
      10.1227/01.NEU.0000255388.03088.B7.