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      Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion: Clinical and Radiological Results of Mean 46-Month Follow-Up

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      1 , 2 , 1 , *
      BioMed Research International
      Hindawi Publishing Corporation

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          Abstract

          Background. Spinal fusion has been shown to be the preferred surgical option to reduce pain, recover function, and increase quality of life in the treatment of a variety of lumbar spinal disorders. The main goal of the present study is to report our clinical experience and results of percutaneous transforaminal endoscopic lumbar interbody fusion (PELIF) applications using the expandable spacer in a single institution. Methods. We performed a retrospective review of 18 patients with >12-month follow-up who had been operated on PELIF using expandable spacer from 2001 to 2007. Their clinical and radiological data were collected and analyzed. Results. The mean follow-up period was 46 months. The mean DH before the surgery was 8.3 mm which improved to 11.4 mm at the early postoperative period and regressed to 9.3 mm at the last follow-up visit. The VAS-B, VAS-L, and ODI scores at the last follow-up showed a 54%, 72%, and 69% improvement from the preoperative period, respectively. Conclusions. The presented PELIF technique with the expandable spacer seems to be a promising surgical technique for the treatment of a variety of lumbar spinal disorders. Conversely, radiological results including disc space subsidence make the stand-alone application of the expandable spacer debatable.

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          Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases.

          Prospective cohort study. To determine whether minimally invasive transforaminal lumbar interbody fusion (TLIF) using the tubular retractor system reduces the approach-related morbidity inherent in conventional open surgery. Posterior lumbar fusion using the tubular retractor system has been reported and described well. Supporters have claimed that minimally invasive techniques reduce soft-tissue trauma, blood loss, postoperative pain, transfusion needs, and the length of hospital stay, as compared with reports describing the traditional open procedure. However, there are few studies of minimally invasive TLIF, especially studies that directly compared minimally invasive and open approaches in a single center. Between May 2005 and December 2006, a total of 62 patients underwent 1-level TLIF by 1 surgeon in 1 hospital. Of 62 patients, 32 underwent minimally invasive TLIF using the tubular retractor system, and the other 30 underwent the traditional open procedure. The operative duration, blood loss, complications, and recovery time were recorded. The clinical outcomes were evaluated by the Oswestry Disability Index and the Visual Analog Scale. The soft-tissue injury was assessed by measuring serum creatine kinase. Radiographic images were obtained before surgery and during follow-up. The minimally invasive group was found to have reduced blood loss, fewer transfusions, less postoperative back pain, lower serum creatine kinase on the third postoperative day, a shorter time to ambulation, and a briefer hospital stay. The Oswestry Disability Index and Visual Analog Scale scores were significantly lower in the minimally invasive group during follow-up. However, the open group had a shorter operative duration. The complications in the 2 groups were similar, but 2 cases of screw malposition occurred in the minimally invasive group. Minimally invasive TLIF as a management of 1-level degenerative lumbar diseases is superior to the traditional open procedure in terms of postoperative back pain, total blood loss, need for transfusion, time to ambulation, length of hospital stay, soft-tissue injury, and functional recovery. However, this procedure takes longer operative duration and requires close attention to the risk of technical complications. Longer-term studies involving a larger sample are needed to validate the long-term efficacy of minimally TLIF.
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            Arthrodesis by the distraction-compression method using a stainless steel implant.

            G Bagby (1988)
            A new process for arthrodesis in humans is presented. The process has been used successfully in the cervical spine of horses and has potential for human use. The concept is encompassed in the process of an anterior cervical fusion and is an adaptation of that established practice but using an implant of stainless steel containing autogenous bone graft to encourage through-the-implant growth of bone. In the future, it may have use in the human spine and other joints.
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              Percutaneous endoscopic transforaminal lumbar interbody fusion: is it worth it?

              Interbody spine fusion with cages was first described by Bagby and has been performed for a long time now in a variety of different conditions. We developed a percutaneous endoscopic lumbar fusion technique based on the principles of Kambin and an original titanium cage.
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                Author and article information

                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi Publishing Corporation
                2314-6133
                2314-6141
                2017
                27 February 2017
                : 2017
                : 3731983
                Affiliations
                1Department of Neurological Surgery, Spine Health Wooridul Hospital, Seoul, Republic of Korea
                2Department of Orthopaedic Surgery, Spine Health Wooridul Hospital, Seoul, Republic of Korea
                Author notes

                Academic Editor: William B. Rodgers

                Author information
                http://orcid.org/0000-0003-0042-7242
                Article
                10.1155/2017/3731983
                5350405
                28337448
                3c76f634-d747-4458-be23-e507b8e3e906
                Copyright © 2017 Sang-Ho Lee et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 8 November 2016
                : 30 January 2017
                : 6 February 2017
                Categories
                Clinical Study

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