Percutaneous posterior interbody fusion with B-twin in degenerative lumbar diseases:a short-term study on 41 cases
- VernacularTitle:经皮椎体间融合术治疗退行性下腰椎疾患的近期疗效观察
- Author:
Jiang GUO
;
Xiangrong CHEN
;
Guoxi XU
- Publication Type:Journal Article
- Keywords:
percutaneous posterior lumbar interbody fusion;
surgical procedures,minimally invasive;
spinal fusion;
B-twin
- From:Journal of Third Military Medical University
1984;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the short-term clinical outcome of percutaneous posterior lumbar interbody fusion using B-twin stand-alone expandable spinal spacer in the degenerative lumbar diseases.Methods From January 2006 to March 2009,41 consecutive patients with lumbar degenerative disc diseases were enrolled and 44 intervertebral spaces were observed in this study.There were 20 males and 21 females,with an average age of 57.51(ranging from 31 to 77 years old).Indications for treatment included degenerative lumbar disc herniation(LDH) with intervertebral instability or Ⅰ? spondylolisthesis(25 cases),LDH with intervertebral space collapse(15 cases) and lumbar discogenic pain(1 case).Fusion segments included 3 cases of L3,L4 and L5,3 cases of L3 and L4,27 cases of L4 and L5,and 8 cases of L5 and S1.After percutaneous discectomy and endplate,curettage were meticulously carried out.A B-twin expandable spinal spacer was introduced into the intervertebral space and then expanded and an allograft cancellous bone of 4 to 5 g was implanted around the B-twin in the intervertebral space.The whole operation was monitored by C-arm fluoroscopy.The clinical outcome was evaluated by JOA scale and X-rays and CT examination before the operation,and 1 week,3 and 12 months after the operation.Results After follow-up of 3 to 38 months(mean 16 months),all the patients were evaluated,and excellent was obtained in 13 cases,good in 21 cases,fair in 5 cases,and poor in 2 cases.The excellent and good rate was 82.93% according to the JOA scale.X-rays and CT showed that the subsidence of the B-twin was found in 3 cases,and 1 case was significantly subsided by more than 20%.Cage shift was seen in 1 case.Conclusion Percutaneou posterior lumbar interbody fusion with B-twin is efficient with minimal surgical trauma,blood loss,better rehabilitation and reliable short-term outcome.Strict indications and pinpoint skills for surgery are the precondition to obtain satisfactory outcome in the treatment of degenerative disc disease.