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2013년 11월 12일 화요일

Clinical and Radiologic Outcomes of TLIF Applications With or Without Pedicle Screw: A Double Center Prospective Pilot Comparative Study

Brief review


*Title: Clinical and Radiologic Outcomes of TLIF Applications With or Without Pedicle Screw: A Double Center Prospective Pilot Comparative Study
척추경나사 사용 유무에 따른 추간공경유 요추 유합술의 임상적, 방사선학적 결과
: 두 기관의 예비 전향적 비교 연구

*Author: Kadir Kotil, Mustafa Ali Akc¸etin, Yildiray Savas



STUDY DESIGN
Prospective cohort data by merging data from comparative studies.


OBJECTIVE
To compare clinical and radiologic outcomes of the transforaminal lumbar interbody fusion (TLIF) procedure with or without pedicle screw support in stable patients with a degenerative disease.


SUMMARY OF BACKGROUND DATA
-TLIF is routinely performed with the support of pedicle screws.
-Problem: TLIF procedure without pedicle screw support has not yet been reported.


METHODS
Period: 2006.02 ~ 2009.05
Subject: patients underwent decompression and fusion (using TLIF)
-Group A: TLIF with pedicle screw (n=30)
-Group B: TLIF without pedicle screw (n=30)
Mean follow-up period: 31mon
Mean age: 45.5 yrs


RESULTS



group A
group B
Sex ratio (female: male)
19:11
18:12
Pseudoarthrosis (patients)
2
3
Mean operating time (min)
110
73
Mean blood loss (mL)
410
220
Cage loosening (patients)
0
1
sciatic pain
4
1

-VAS, ODI (after 1months):  A > B (P<0.005)
                 (after 3 months): Not significantly differ (P<0.89).

-Cost: A(3-fold higher) > B


CONCLUSIONS
-TLIF procedure without pedicle screw would be sufficient in the management of stable patients with lumbar degenerative disease after single-level decompression.

-And this technique is less costs and complications compared with pedicle screwing.