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Treatment of Patients with Degenerative Diseases of the Lumbosacral Spine Using a Novel Technology of Facet Stabilization with Facet Wedge Implant

Treatment of Patients with Degenerative Diseases of the Lumbosacral Spine Using a Novel Technology of Facet Stabilization with Facet Wedge Implant

Kalinin A.A., Okoneshnikova A.K., Byvaltsev V.A.
Key words: stabilization of facet joints; transpedicular fixation; spinal canal decompression; lumbar spine; degenerative lesion of the intervertebral disc; TLIF.
2017, volume 9, issue 2, page 131.

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Transpedicular fixation with interbody fusion widely used in management of degenerative diseases of the lumbosacral spine is associated with significant intraoperative aggression during surgery and postsurgical pain syndrome. To improve treatment results, a novel minimally invasive technology of facet fixation with Facet Wedge implant in combination with transpedicular stabilization and interbody fusion has been introduced.

The aim of the investigation was to evaluate the efficacy of facet fixation technology with Facet Wedge implant in combination with transpedicular stabilization and interbody fusion in treatment of patients with degenerative diseases of the lumbosacral spine.

Materials and Methods. The study involved 19 patients who underwent unilateral decompression with transforaminal lumbar interbody fusion, ipsilateral transpedicular stabilization and facet fixation on the contralateral side, according to clinical and instrumental indications. The minimum follow-up period of observation and complex evaluation of treatment results was 12 months.

Results. When assessing pain syndrome by visual analogue scale and the degree of disability according to Oswestry disability index in the early postoperative period and in the long-term period, mostly good and excellent outcomes, statistically significantly better results were observed compared to the preoperative values. An interbody bone block was formed within 12 months in 89% (n=17) of patients, according to radiographic data.

Conclusion. Decompression with a novel minimally invasive technology of combined dorsal fusion provides the possibility to significantly reduce pain, lower the degree of disabilityand implement efficient stabilization of the operated functional spinal segment in patients with degenerative diseases of the lumbosacral spine.

  1. Byvaltsev V.A., Sorokovikov V.A., Kalinin A.A., Egorov A.V., Belykh E.G., Panasenkov S.Yu. Comparative analysis of the results of decompression and single-stage decompression-and-stabilizing operations at the treatment of discoradicular conflict of lumbosacral segment of spine. Byulleten’ Vostochno-Sibirskogo nauchnogo tsentra Sibirskogo otdeleniya Rossiyskoy Akademii meditsinskikh nauk 2011; 4(1): 38–43.
  2. Krutko A.V. Comparative analysis of posterior interbody fusion and transforaminal interbody fusion in combination with transpedicular fixation. Vestnik travmatologii i ortopedii im. N.N. Priorova 2012; 1: 12–21.
  3. Mobbs R.J., Phan K., Malham G., Seex K., Rao P.J. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg 2015; 1(1): 2–18.
  4. Asil K., Yaldiz C. Retrospective comparison of radiological and clinical outcomes of PLIF and TLIF techniques in patients who underwent lumbar spinal posterior stabilization. Medicine 2016; 95(17): e3235, https://doi.org/10.1097/md.0000000000003235.
  5. Harms J., Rolinger H. A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion. Z Orthop Unfall 1982; 120(3): 343–347, https://doi.org/10.1055/s-2008-1051624.
  6. Jin-Tao Q., Yu T., Mei W., Xu-Dong T., Tian-Jian Z., Guo-Hua S., Lei C., Yue H., Zi-Tian W., Yue Z. Comparison of MIS vs. open PLIF/TLIF with regard to clinical improvement, fusion rate, and incidence of major complication: a meta-analysis. Eur Spine J 2015; 24(5): 1058–1065, https://doi.org/10.1007/s00586-015-3890-5.
  7. Goldstein C.L., Macwan K., Sundararajan K., Rampersaud Y.R. Comparative outcomes of minimally invasive surgery for posterior lumbar fusion: a systematic review. Clin Orthop Relat Res 2014; 472(6): 1727–1737, https://doi.org/10.1007/s11999-014-3465-5.
  8. Byvaltsev V.A., Kalinin A.A., Belykh E.G., Sorokovikov V.A., Shepelev V.V. Optimization of segmental lumbar spine instability treatment using minimally invasive spinal fusion technique. Voprosy neirokhirurgii im. N.N. Burdenko 2015; 79(3): 45–54, https://doi.org/10.17116/neiro201579345-54.
  9. Sakeb N., Ahsan K. Comparison of the early results of transforaminal lumbar interbody fusion and posterior lumbar interbody fusion in symptomatic lumbar instability. Indian J Orthop 2013; 47(3): 255, https://doi.org/10.4103/0019-5413.111484.
  10. José-Antonio S.-S., Baabor-Aqueveque M., Silva-Morales F. Philosophy and concepts of modern spine surgery. Acta Neurochir Suppl 2011; 108: 23–31, https://doi.org/10.1007/978-3-211-99370-5_5.
  11. Pellisé F., Hernández A., Vidal X., Minguell J., Martínez C., Villanueva C. Radiologic assessment of all unfused lumbar segments 7.5 years after instrumented posterior spinal fusion. Spine 2007; 32(5): 574–579, https://doi.org/10.1097/01.brs.0000256875.17765.e6.
  12. Magerl F.P. Stabilization of the lower thoracic and lumbar spine with external skeletal fixation. Clin Orthop Relat Res 1984; (189): 125–141, https://doi.org/10.1097/00003086-198410000-00014.
  13. Buttermann G.R., Thorson T.M., Mullin W.J. Outcomes of posterior facet versus pedicle screw fixation of circumferential fusion: a cohort study. Eur Spine J 2013; 23(2): 347–355, https://doi.org/10.1007/s00586-013-2999-7.
  14. Chin K.R., Seale J., Cumming V. Mini-open or percutaneous bilateral lumbar transfacet pedicle screw fixation. J Spinal Disord Tech 2015; 28(2): 61–65, https://doi.org/10.1097/bsd.0b013e31827fe17e.
  15. Kretzer R.M., Molina C., Hu N., Umekoji H., Baaj A.A., Serhan H., Cunningham B.W. A comparative biomechanical analysis of stand alone versus facet screw and pedicle screw augmented lateral interbody arthrodesis: an in vitro human cadaveric model. Clin Spine Surg 2016; 29(7): E336–E343, https://doi.org/10.1097/bsd.0b013e3182868ef9.
  16. Fujiwara A., Lim T.H., An H.S., Tanaka N., Jeon C.H., Andersson G.B., Haughton V.M. The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 2000; 25(23): 3036–3044, https://doi.org/10.1097/00007632-200012010-00011.
  17. Wiltse L.L., Spencer C.W. New uses and refinements of the paraspinal approach to the lumbar spine. Spine 1988; 13(6): 696–706, https://doi.org/10.1097/00007632-198806000-00019.
  18. Byval’tsev V.A., Belykh E.G., Sorokovikov V.A., Arsent’eva N.I. The use of scales and questionnaires in vertebrology. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova 2011; 111(9–2): 51–56.
  19. Madill H.M., Brintnell E.S.G., Fitzsimmons G.W., Stewin L.L., Macnab D., Casserly M.C. Work related issues in occupational therapy: your values do count. Canadian Journal of Occupational Therapy 1986; 53(1): 13–18, https://doi.org/10.1177/000841748605300102.
  20. Skovrlj B., Gilligan J., Cutler H.S., Qureshi S.A. Minimally invasive procedures on the lumbar spine. World J Clin Cases 2015; 3(1): 1, https://doi.org/10.12998/wjcc.v3.i1.1.
  21. Xue H., Tu Y., Cai M. Comparison of unilateral versus bilateral instrumented transforaminal lumbar interbody fusion in degenerative lumbar diseases. Spine J 2012; 12(3): 209–215, https://doi.org/10.1016/j.spinee.2012.01.010.
  22. Mason R., Tennekes H., Sánchez-Bayo F., Uhd Jepsen P. Immune suppression by neonicotinoid insecticides at the root of global wildlife declines. J Environ Immunol Toxicol 2014; 1(1): 3–12, https://doi.org/10.7178/jeit.1.
  23. Yang X., Wang H., Zhao Q., Xu H., Liu P., Jin Y. A comparison of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion for lumbar degenerative diseases. Chin Med J (Engl) 2014; 127(20): 3592–3596.
  24. Zhao J., Zhang F., Chen X., Yao Y. Posterior interbody fusion using a diagonal cage with unilateral transpedicular screw fixation for lumbar stenosis. J Clin Neurosci 2011; 18(3): 324–328, https://doi.org/10.1016/j.jocn.2010.06.007.
  25. Sethi A., Muzumdar A.M., Ingalhalikar A., Vaidya R. Biomechanical analysis of a novel posterior construct in a transforaminal lumbar interbody fusion model an in vitro study. Spine J 2011; 11(9): 863–869, https://doi.org/10.1016/j.spinee.2011.06.015.
  26. Tuli S.K., Eichler M.E., Woodard E.J. Comparison of perioperative morbidity in translaminar facet versus pedicle screw fixation. Orthopedics 2005; 28(8): 773–778.
  27. Hartensuer R., Riesenbeck O., Schulze M., Gehweiler D., Raschke M.J., Pavlov P.W., Vordemvenne T. Biomechanical evaluation of the Facet Wedge: a refined technique for facet fixation. Eur Spine J 2014; 23(11): 2321–2329, https://doi.org/10.1007/s00586-014-3533-2.
  28. Jang J.-S., Lee S.-H. Minimally invasive transforaminal lumbar interbody fusion with ipsilateral pedicle screw and contralateral facet screw fixation. J Neurosurg Spine 2005; 3(3): 218–223, https://doi.org/10.3171/spi.2005.3.3.0218.
  29. Jiang X., Feng Z., Liu F., Jiang C., Cao Y. Transforaminal lumbar interbody fusion using unilateral pedicle screw fixation plus contralateral translaminar facet screw fixation in lumbar degenerative diseases. Indian J Orthop 2014; 48(4): 374, https://doi.org/10.4103/0019-5413.136240.
  30. Xu J., Mao K., Wang Y., Xiao S., Li P., Mao K., Xiao B., Wang Y. A feasibility research of minimally invasive transforaminal lumbar interbody fusion using unilateral incision and hybrid internal fixation for dural-level lumbar degenerative disease. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2013; 27(8): 955–959.
  31. Mao K.Y., Wang Y., Xiao S.H., Zhang Y.G., Liu B.W., Wang Z., Zhang X.F., Cui G., Zhang X.S., Li P., Mao K.Z. A feasibility research of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation for recurrent lumbar disc herniation. Zhonghua Wai Ke Za Zhi 2013; 51(8): 723–727.
  32. Shao R.X., Luo P., Lin Y., Xu H.Z., Chi Y.L. Treatment of low lumbar degenerative disease with unilateral pedicle screw combined with contralateral percutaneous transfacet screws fixation. Zhongguo Gu Shang 2015; 28(4): 318–322.
Kalinin A.A., Okoneshnikova A.K., Byvaltsev V.A. Treatment of Patients with Degenerative Diseases of the Lumbosacral Spine Using a Novel Technology of Facet Stabilization with Facet Wedge Implant. Sovremennye tehnologii v medicine 2017; 9(2): 131, https://doi.org/10.17691/stm2017.9.2.16


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