MINIMALY INVASIVE SURGERY FOR DEGENERATIVE SEGMENTAL INSTABILITY OF THE LUMBAR SPINE
Authors: Kerimbayev Т.Т., Aleinikov V.G., Sypabekov S.Zh., Urunbayev Y.A., Kissayev Y.V., Yerezhepbekov B.S.
Number of views: 360
Objectives. To evaluate the effectiveness of
tubular access technique of interbody PLIF- Cage fusion
and percutaneous pedicle fixation.
Methods. Radiological and clinical outcomes were
evaluated, including the MRI, CT , X-ray with functional
loads, electroneuromyography, Visual analog score
(VAS) for lower back pain (VAS-BP) and leg pain (VASLP),
and Oswestry Disability Index, before admission
, at discharge and at 3, 6, 12 months after surgery.
The average follow-up was 6 - 12 months. The tubular
Access through (Quadrant ®, Medtronic) retractor with
microscopic discectomy and PLIF - Cage (PEEK cage
Capstone ®, Medtronic) and percutaneous pedicle
screw fixation with the Sextant 2 , Medtronic and Viper 2 ,
De Puy system, was performed.
Results. Clinical VAS-BP, VAS-LP and JOA scores
were significantly improved at (P<0,05) between the
preoperative period (average, 6/10) and on the day of
discharge (on average, 2/10 ) , in ODI scale also noted
improvement (P <0,07) compared to the pre-operation
(average 43,5 %) after discharge (12,8 %). At the follow
up period of 6 - 12 months the relief of clinical symptoms
was observed in 38 patients, residual back pain in 6
patients, moderate radicular pain in 3 cases. Good
consolidation according to CT observed in the majority
of cases, insufficient in 2 – osteoporotic patients . The
mean postoperative hospital stay was 7,5 days.
Conclusion. The minimally invasive posterior
lumbar interbody fusion through a unilateral approach
and subsequent tubular percutaneous fixation is an
effective method of surgery for vertebral-motion segment
Key words: spinal instability, spodylolistes,
percutaneous transpedicular fixation, PLIF- cage.