J Korean Soc Spine Surg.  2007 Sep;14(3):171-177. 10.4184/jkss.2007.14.3.171.

Posterior Lumbar Intebody Fusion with Unilateral Transpedicular Screw and Contralateral Translaminar Facet Screw Fixation in Lumbar Spinal Stenosis

• Kim KS
• Choi YS
• Lim CH
• Park KH

• KMID: 1941649
• DOI: http://doi.org/10.4184/jkss.2007.14.3.171

Abstract

STUDY DESIGN: A retrospective study.
OBJECTIVES
To describe the surgical procedure and assess the results of an unilateral transpedicular screw and contralateral translaminar facet screw fixation in degenerative lumbar stenosis. SUMMARY OF LITERATURE REVIEW: A drawback of conventional lumbar fusion is the extensive soft-tissue destruction that is essential when inserting a screw and preparing the fusion bed. The development of a procedure that minimizes the tissue trauma without compromising the effectiveness of the conventional posterior lumbar interbody fusion (PLIF) should be pursued in lumbar spinal stenosis.
MATERIALS AND METHODS
From August 2004 to November 2005, PLIF was performed on 25 consecutive patients who had lumbar spinal stenosis. Among them, 10 patients underwent with unilateral transpedicular screw and contralateral translaminar facet screw fixation (Group 1), and 15 patients underwent traditional bilateral transpedicular screw fixation (Group 2). The clinical and radiological results in the two groups were compared.
RESULTS
The mean follow-up was 17.6 and 20.5 months in Groups 1 and 2, respectively. Group 1 had less blood loss, fewer transfusion requirements (P.0.05) in the surgical procedure, and less postoperative back pain (P.0.05). There was no significant difference between the two groups in the clinical results such as the VAS score for back pain and the Kirkadly-Willis criteria at the last follow-up, and the radiological results such as the changes in the disc height and interbody fusion.
CONCLUSION
The PLIF with unilateral transpedicular screw and contralateral translaminar facet screw fixation in lumbar spinal stenosis has advantages over conventional PLIF of less soft tissue injury, and produces good clinical results.

Keyword

Lumbar spinal stenosis; Posterior lumbar interbody fusion; Translaminar facet screw

MeSH Terms

Back Pain
Constriction, Pathologic
Follow-Up Studies
Humans
Retrospective Studies
Soft Tissue Injuries
Spinal Stenosis*

Figure

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  Fig. 1. (A) An operative finding shows unilateral transpedicular fixation and screw head at spinous process for contralateral facet fixation. (B) The schematic presentation shows unilateral transpedicular screw fixation and contralateral facet screw fixation.

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  Fig. 2. (A) The radiographs demonstrate posterior lumbar interbody fusion with cage and unilateral pedicular screw fixation and contralateral facet screw fixation. (B) On radiographs at 24 months follow up after operation shows well interbody fusion.

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