PMID- 26926356
OWN - NLM
STAT- MEDLINE
DCOM- 20170608
LR  - 20210113
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 41
IP  - 17
DP  - 2016 Sep
TI  - Comparison of Clinical and Radiographic Outcomes in Patients Receiving 
      Single-Level Transforaminal Lumbar Interbody Fusion With Removal of Unilateral or 
      Bilateral Facet Joints.
PG  - E1039-E1045
LID - 10.1097/BRS.0000000000001535 [doi]
AB  - STUDY DESIGN: A retrospective cohort study. OBJECTIVE: The objective of this 
      study is to compare the radiographic and clinical outcomes of transforaminal 
      lumbar interbody fusion (TLIF) with bilateral facetectomy (BF) versus unilateral 
      facetectomy (UF). SUMMARY OF BACKGROUND DATA: BF is a surgical technique utilized 
      with the intent of creating a greater degree of segmental lordosis than UF alone. 
      However, the clinical benefits of this technique have not been defined. We seek 
      to determine whether a difference exists between bilateral versus UF during TLIF 
      by utilizing both clinical and radiographic outcome measures. METHODS: The 
      electronic medical records of 57 patients who underwent single-level TLIF with 
      either a UF (n = 28) or BF (n = 29) were reviewed. Clinical outcomes were 
      measured through Patient Health Questionnaire-9 (PHQ-9), Pain Disability 
      Questionnaire (PDQ), EuroQol 5 Dimensions (EQ-5D) Health State, and Quality 
      Adjusted Life Year (QALY). Radiographic parameters including disc height and 
      sagittal balance were measured on plain radiographs at 1 year following 
      operation. RESULTS: All radiographic parameters showed no significant differences 
      between the UF and BF cohorts. Segmental lordosis increased significantly in both 
      cohorts. However, there was no significant difference in the increase of 
      segmental lordosis between cohorts. Overall lumbar lordosis did not increase 
      significantly in either cohort. Perioperative complications were also similar 
      between cohorts. PDQ and EQ-5D scores improved significantly in both cohorts at 1 
      year postoperatively. The BF cohort showed a significantly greater improvement in 
      both EQ-5D (0.1 +/- 0.2 vs. 0.3 +/- 0.2, P = 0.01) and PHQ-9 scores (-0.8 +/- 4.6 vs. 
      4.6 +/- 5.2, P = 0.03) than the UF cohort. The PDQ score improved over the 
      minimally clinical important difference (MCID) of 26 in only the BF cohort. 
      CONCLUSION: The findings in the present study demonstrate that BF during 
      single-level TLIF improves clinical outcomes to a greater degree than UF without 
      any notable differences in perioperative complications or radiographic 
      measurements. LEVEL OF EVIDENCE: 3.
FAU - Tye, Erik Y
AU  - Tye EY
AD  - Case Western Reserve University School of Medicine, Cleveland, OH.
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH.
AD  - Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH.
FAU - Alentado, Vincent J
AU  - Alentado VJ
AD  - Case Western Reserve University School of Medicine, Cleveland, OH.
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH.
AD  - Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH.
FAU - Mroz, Thomas E
AU  - Mroz TE
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH.
AD  - Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH.
FAU - Orr, R Douglas
AU  - Orr RD
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH.
AD  - Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH.
FAU - Steinmetz, Michael P
AU  - Steinmetz MP
AD  - Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH.
AD  - Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
CIN - Spine (Phila Pa 1976). 2017 Mar;42(5):E318-E319. PMID: 28244973
MH  - Adult
MH  - Aged
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - Lordosis/*etiology
MH  - Lumbar Vertebrae/*surgery
MH  - Lumbosacral Region/*surgery
MH  - Male
MH  - Middle Aged
MH  - Minimally Invasive Surgical Procedures/methods
MH  - Retrospective Studies
MH  - *Spinal Fusion/methods
MH  - Spondylolisthesis/*surgery
MH  - Treatment Outcome
MH  - Young Adult
MH  - Zygapophyseal Joint/*surgery
EDAT- 2016/03/02 06:00
MHDA- 2017/06/09 06:00
CRDT- 2016/03/02 06:00
PHST- 2016/03/02 06:00 [entrez]
PHST- 2016/03/02 06:00 [pubmed]
PHST- 2017/06/09 06:00 [medline]
AID - 00007632-201609010-00007 [pii]
AID - 10.1097/BRS.0000000000001535 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2016 Sep;41(17):E1039-E1045. doi: 
      10.1097/BRS.0000000000001535.