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2014년 2월 24일 월요일

Clinical analysis of percutaneous facet screw fixation after anterior lumbar interbody fusion

Brief review

논문은 전방경유요추체유합술 후의 경피적 나사못 고정술 시행의 임상적 결과를 연구한 내용 입니다.
percutaneous facet screw fixation 시행 그룹을 실험군으로, pedicle screw fixation 시행 그룹을 대조군으로 설정하여 수술 , 후의 ODI(장애지수) MacNab(만족도) 조사하여 비교했습니다.
수술 시행 최소 2년의 기간 동안 추적조사 결과, 그룹 간에는 임상적으로 유의한 차이가 없었습니다.
percutaneous facet screw fixation 요추체 유합술과 함께 시행할 때에 안전하고 최소침습적인 치료법이라는 결론 입니다.


*Title: Clinical analysis of percutaneous facet screw fixation after anterior lumbar interbody fusion.
전방경유 요추체 유합술 후 경피적 나사못 고정술 시행의 임상적인 분석

*Authors: JEE-SOO Jang, SANG-HO Lee.
*Bibliography: J Neurosurg Spine. 2005 Jul;3(1):40-6.


STUDY DESIGN
Retrospective study


OBJECT
To evaluate the results of percutaneous facet screw fixation (PFSF) after anterior lumbar interbody fusion (ALIF) in comparison with the post-ALIF pedicle screw fixation (PSF).


METHODS
Subject number: 84 patients (treated for degenerative spondylolisthesis or degenerative disc disease)

Grouping
-group1: 44 underwent percutaneous facet screw fixation
-group2: 40 underwent pedicle screw fixation (control group)

Evaluating method
-Functional outcome: using Oswestry Disability Index (ODI), Macnab criteria.
-Radiologic outcome: dynamic lateral (flexion-extension) radiography and CT scanning (to evaluate the osseous union status)

Follow up period: min 2 yrs


RESULTS
Functional outcome: ODI and Macnab outcome- no significant difference between 2 groups (p > 0.05).
-Excellent or good outcome: 40 (90.9%) of the 44 patients (Group 1) and 37 (92.5%) of the 40 patients (Group 2) (p > 0.05).

-No patient required a blood transfusion in either group.

Fusion rates: 95.8% (Group 1) and 97.5% (Group 2) -at 24 months after surgery


CONCLUSIONS
-There are no significant difference in clinical outcome between percutaneous facet screw fixation and pedicle screw fixation after ALIF.


-Percutaneous facet screw fixation represents a safe and minimally invasive modality with which to achieve solid fusion in the lumbar spine.