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Titolo:
Minimally invasive 360 degrees instrumented lumbar fusion
Autore:
Thalgott, JS; Chin, AK; Ameriks, JA; Jordan, FT; Giuffre, JM; Fritts, K; Timlin, M;
Indirizzi:
Int Spinal Dev & Res Fdn, Las Vegas, NV 89106 USA Int Spinal Dev & Res Fdn Las Vegas NV USA 89106 , Las Vegas, NV 89106 USA Univ Nevada, Sch Med, Las Vegas, NV 89154 USA Univ Nevada Las Vegas NV USA 89154 vada, Sch Med, Las Vegas, NV 89154 USA
Titolo Testata:
EUROPEAN SPINE JOURNAL
, volume: 9, anno: 2000, supplemento:, 1
pagine: S51 - S56
SICI:
0940-6719(200002)9:<S51:MI3DIL>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
LAPAROSCOPIC SPINAL-FUSION; ANTERIOR INTERBODY FUSION; CIRCUMFERENTIAL FUSION; POSTERIOR FUSION; DISKECTOMY; COMPLICATIONS; MULTICENTER; PAIN; DISK;
Keywords:
minimally invasive; 360 degrees lumbar fusion; combined anteroposterior; gasless endoscopy; translaminar fixation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Thalgott, JS Int Spinal Dev & Res Fdn, 500 S Rancho Dr,Suite 8A, Las Vegas, NV 89106 USA Int Spinal Dev & Res Fdn 500 S Rancho Dr,Suite 8A Las Vegas NV USA 89106
Citazione:
J.S. Thalgott et al., "Minimally invasive 360 degrees instrumented lumbar fusion", EUR SPINE J, 9, 2000, pp. S51-S56

Abstract

A retrospective preliminary study was undertaken of combined minimally invasive instrumented lumbar fusion utilizing the BERG (balloon-assisted endoscopic retroperitoneal gasless) approach anteriorly, and a posterior small-incision approach with translaminar screw fixation and posterolateral fusion. The study aimed to quantify the clinical and radiological results using this combined technique. The traditional minimally invasive approach to the anterior lumbar spine involves gas insufflation and provides reliable access only to L5-S1 and in some cases L4-5. A gas-mediated approach yields manytechnical drawbacks to performing spinal surgery. A minimally invasive posterior approach involving suprafascial pedicle screw instrumentation has been developed, but without widespread use. Translaminar facet fixation may be a viable alternative to transpedicular fixation in a 360 degrees instrumented fusion model. Past studies have shown open 360 degrees instrumented lumbar fusion yields high arthrodesis rates. The study examined the cases of 46 patients who underwent successful 360 degrees instrumented lumbar fusionusing a combined minimally invasive approach. Anterior lumbar interbody fusion (ALIF) at one or two levels was performed through the BERG approach; agasless retroperitoneal approach to the lumbar spine allowing the use of standard anterior instrumentation. Posteriorly, all patients underwent successful decompression, translaminar fixation, and posterolateral fusion at one or two levels through one small (2.5-5.0 cm) incision. Results showed mean hospital stay of 2.02 days; mean combined blood loss was 255 cc; and meanpain relief was 56%, with 75.5% of patients reporting good, excellent, or total pain relief. Forty-two of 46 patients (93.2%) achieved a solid fusion24 months after surgery. A total of 47% of all patients working prior to surgery returned to work following surgery. The study showed that minimally invasive 360 degrees instrumented lumbar fusion, when performed utilizing these approaches, yields a high rate of solid arthrodesis (93.3%), good painrelief, short hospital stays, low blood losses, accelerated rehabilitation, and a quick return to the workforce. The BERG approach offers technical advantages over the traditional gas-mediated laparoscopic approach to the anterior lumbar spine.

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Documento generato il 15/07/20 alle ore 21:01:01