Instrumentation-related complications of lumbar degenerative disc diseases treated by minimally invasive transforaminal lumbar interbody fusion  

作　　者：Xinyu Yang Xinyu Liu 

机构地区：[1]Department of Orthopedics,Qilu Hospital of Shandong University,Ji’nan 250012,Shandong,China

出　　处：《Brain Science Advances》2019年第3期213-219,共7页神经科学（英文）

基　　金：supported by the National Natural Science Foundation of China(No.81272024).

摘　　要：Objective:To analyze the instrumentation-related complications of patients with lumbar degenerative disc diseases(LDD)who underwent minimally invasive transforaminal lumbar interbody fusion(MISTLIF)and to discuss the potential strategy for the control of these complications.Methods:A total of 87 patients with LDD were treated with the MIS-TLIF procedure.Complications,including malposition or breakage of guide pin,percutaneous pedicle screw(PPS)or cages,neurological deficit,and superior-level facet joint violations,were determined during and after the surgery.Computed tomography(CT)was used to evaluate the PPS accuracy and the superior-level facet joint violations.Results:A total of 386 PPSs were used.During the surgery,3(0.8%)guide pin and 1(0.3%)PPS perforated the anterior wall of the vertebral body,respectively.One(0.3%)PPS was pulled out during the reduction of slip.Malposition of the cages occurred in 6(1.6%)PPSs.These were all adjusted accordingly during the surgery.All the patients received>2 years of follow-up.No loosening or breakage of PPS and cage was observed,but CT showed 27(7.0%)PPSs misplaced.No neurological deficit related to misplaced PPS was observed.The total facet joint violation(FJV)rate was 36.2%,with grade 2 and grade 3 violations is 21(12.1%)and 6(3.4%),respectively.Conclusion:MIS-TLIF has similar instrumentation-related complications with open TLIF.Accurate preoperative evaluation and improved surgical techniques can effectively reduce these instrumentation-related complications.Objective: To analyze the instrumentation-related complications of patients with lumbar degenerative disc diseases(LDD) who underwent minimally invasive transforaminal lumbar interbody fusion(MISTLIF) and to discuss the potential strategy for the control of these complications. Methods: A total of 87 patients with LDD were treated with the MIS-TLIF procedure. Complications, including malposition or breakage of guide pin, percutaneous pedicle screw(PPS) or cages, neurological deficit, and superior-level facet joint violations, were determined during and after the surgery. Computed tomography(CT) was used to evaluate the PPS accuracy and the superior-level facet joint violations. Results: A total of 386 PPSs were used. During the surgery, 3(0.8%) guide pin and 1(0.3%) PPS perforated the anterior wall of the vertebral body, respectively. One(0.3%) PPS was pulled out during the reduction of slip. Malposition of the cages occurred in 6(1.6%)PPSs. These were all adjusted accordingly during the surgery. All the patients received > 2 years of follow-up. No loosening or breakage of PPS and cage was observed, but CT showed 27(7.0%) PPSs misplaced. No neurological deficit related to misplaced PPS was observed. The total facet joint violation(FJV) rate was 36.2%, with grade 2 and grade 3 violations is 21(12.1%) and 6(3.4%), respectively.Conclusion: MIS-TLIF has similar instrumentation-related complications with open TLIF. Accurate preoperative evaluation and improved surgical techniques can effectively reduce these instrumentation-related complications.

关 键 词：LUMBAR DEGENERATIVE diseases MINIMALLY invasive surgery TRANSFORAMINAL LUMBAR INTERBODY fusion INSTRUMENTATION complication 

分 类 号：R687.3[医药卫生—骨科学]