EFFECTIVENESS OF TRANSFORAMINAL LUMBAR INTERBODY FUSION VIA Luxor RETRACTOR ASSOCIATED WITH Mantis PEDICLE SCREW IN TREATMENT OF MODERATE AND SEVERE LUMBAR SPONDYLOLISTHESIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 HAOYingjie , YULei , ZHANGYan , ZHANGDi , LIZhilei

Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan, 450052, P. R. China;

Corresponding author：

HAOYingjie, Email: 13937183085@163.com

Keywords：

Lumbar spondylol isthesis; Luxor retractor; Transforaminal lumbar interbody fusion; Minimally invasive technique

DOI：

10.7507/1002-1892.20140327

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Objective To evaluate the effectiveness of transforaminal lumbar interbody fusion (TLIF) via Luxor retractor associated with Mantis pedicle screw for the treatment of moderate or severe lumbar spondylol isthesis (LSL). Methods A retrospective analysis was made on the cl inical data of 32 patients with LSL treated with TLIF via Luxor retractor associated with Mantis pedicle screw between June 2010 and June 2012. There were 20 males and 12 females, with the mean age of 48 years (range, 36-69 years). LSL occurred at the L4, 5 in 17 patients and at the L5, S1 in 15 patients. Of them, 18 cases were rated as Meyerding grade Ⅱ, and 14 cases as grade Ⅲ. The disease duration was 8 months to 6 years (mean, 3.5 years). The operation time, intraoperative blood loss, and preoperative and postoperative (1 week and 1 year) intervertebral height and sl ipping angle were recorded, and the sl ipping rate was calculated; Japanese Orthopaedic Association (JOA) score was used for cl inical efficacy assessment. Results The operation time was 90-130 minutes (mean, 110 minutes); intraoperative blood loss was 120-300 mL (mean, 210 mL). Incisions healed by first intention. All patients were followed up 24-36 months (mean, 28 months), and no complications of leakage of cerebrospinal fluid and nerve root injury occurred; X-ray films showed satisfactory reduction of spondylolisthesis and good position of pedicle screw and interbody fusion cage. The mean bone fusion time was 4.0 months (range, 3.8-6.0 months). The JOA score, sl i pping rate, sl i pping angle, and intervertebral height at 1 week and 1 year after operation were significantly improved when compared with preoperative ones (P<0.05), but no significant difference was found between at 1 week and at 1 year after operation (P>0.05). Conclusion TLIF via Luxor retractor associated with Mantis pedicle screw fixation is a safe and effective minimally invasive technique in treating moderate or severe LSL.

Citation： HAOYingjie, YULei, ZHANGYan, ZHANGDi, LIZhilei. EFFECTIVENESS OF TRANSFORAMINAL LUMBAR INTERBODY FUSION VIA Luxor RETRACTOR ASSOCIATED WITH Mantis PEDICLE SCREW IN TREATMENT OF MODERATE AND SEVERE LUMBAR SPONDYLOLISTHESIS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(12): 1509-1513. doi: 10.7507/1002-1892.20140327 Copy

1.	Bozkus H, Dickman CA. Transvertebral interbody cage and pedicle screw fixation for high-grade spondylolisthesis. Case report. J Neurosurg, 2004, 100(1 Suppl Spine):62-65.
2.	赵杰, 沈洪兴, 王炤, 等. 椎体间撑开复位在Ⅱ°峡部型腰椎滑脱症治疗中的作用. 脊柱外科杂志, 2003, 1(1):38-40.
3.	Park Y, Ha JW. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine (Phila Pa 1976), 2007, 32(5):537-543.
4.	刘涛, 李长青, 周跃, 等. 微创手术治疗Ⅰ、Ⅱ度腰椎滑脱症的疗效观察. 中国脊柱脊髓杂志, 2009, 19(5):354-359.
5.	Gille O, Jol ivet E, Dousset V, et al. Erector spine muscle changes on magnetic resonance imaging following lumbar surgery through a posterior approach. Spine (Phila Pa 1976), 2007, 32(11):1236-1241.
6.	Motosuneya T, Asazuma T, Tsuji T, et al. Postoperative change of the cross-sectional area of back musculature after 5 surgical procedures as assessed by magnetic resonance imaging. J Spinal Discord Tech, 2006, 19(5):318-322.
7.	黎庆初, 尹刚辉, 张忠民, 等. 微创Wiltse入路与传统后正中入路手术治疗双节段腰椎管狭窄症的疗效比较. 中国脊柱脊髓杂志, 2012, 22(9):812-817.
8.	Wang J, Zhou Y, Zhang ZF, et al. Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J, 2010, 19(10):1780-1784.
9.	Hyun SJ, Kim YB, Kim YS, et al. Postoperative changes in paraspinal muscle volume:comparison between paramedian interfascial and midline approaches for lumbar fusion. Korean Med Sci, 2007, 22(4):646-651.
10.	Levin DA, Hale JJ, Bendo JA. Adjacent segment degeneration following spinal fusion for degenerative disc disease. Bull NYU Hosp Jt Dis, 2007, 65(1):29-36.
11.	Kim KT, Lee SH, Suk KS, et al. The quantitative analysis of tissue injury markers after mini-open lumbar fusion. Spine (Phila Pa 1976), 2006, 31(6):712-716.
12.	黎庆初, 胡辉林, 刘宝戈, 等. 多裂肌间隙入路微创手术治疗腰椎滑脱症. 中国脊柱脊髓杂志, 2011, 21(4):303-307.
13.	王建, 周跃, 张正丰, 等. 微创经椎间孔腰椎体间融合术治疗腰椎滑脱症的临床研究. 中华外科杂志, 2011, 49(12):1076-1080.
14.	滕海军, 王亮, 郭志良, 等. Quadrant通道下治疗退变性腰椎滑脱的临床疗效. 临床骨科杂志, 2012, 15(5):498-500.
15.	Foley KT, Gupta SK, Justis JR, et al. Percutaneous pedicle screw fixation of the lumbar spine. Neurosurg Focus, 2001, 10(4):E10.
16.	王建, 周跃, 初同伟, 等. 改良内窥镜下行后路腰椎间融合和经皮椎弓根螺钉固定治疗腰椎退变性疾患. 中国脊柱脊髓杂志, 2007, 17(12):908-912.
17.	李立钧, 周炜, 陆晴友, 等. 微创经椎间孔腰椎间融合术治疗下腰椎疾患的初步报告. 中国修复重建外科杂志, 2008, 22(4):501-503.
18.	孟志斌, 李俊, 李洪潮, 等. X-TUBE内镜下椎弓根钉内固定治疗退行性腰椎管狭窄伴腰椎滑脱的近期临床观察. 颈腰痛杂志, 2008, 29(2):124-127.
19.	滕海军, 王亮, 郭志良, 等. Quadrant通道下单切口治疗腰椎滑脱近期疗效观察. 中国修复重建外科杂志, 2010, 24(5):517-520.
20.	钱济先, 李存孝, 龙华, 等. 微创通道结合经皮椎弓根螺钉固定治疗腰椎退变的个体化方案选择. 中国骨科临床与基础研究杂志, 2012, 4(5):325-331.
21.	Poussa M, Remes V, Lamberg T, et al. Treatment of severe spondylol isthesis in adolescence with reduction of fusion in situ:long-term cl inical, radiologic, and functional outcome. Spine (Phila Pa 1976), 2006, 31(5):583-592.
22.	Musacchio M, Patel N, Bagan B, et al. Minimally invasive lumbar laminectomy via a dual-tube technique:evaluation in a cadaver model. Surg Neurol, 2007, 67(4):348-352.

1. Bozkus H, Dickman CA. Transvertebral interbody cage and pedicle screw fixation for high-grade spondylolisthesis. Case report. J Neurosurg, 2004, 100(1 Suppl Spine):62-65.
2. 赵杰, 沈洪兴, 王炤, 等. 椎体间撑开复位在Ⅱ°峡部型腰椎滑脱症治疗中的作用. 脊柱外科杂志, 2003, 1(1):38-40.
3. Park Y, Ha JW. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine (Phila Pa 1976), 2007, 32(5):537-543.
4. 刘涛, 李长青, 周跃, 等. 微创手术治疗Ⅰ、Ⅱ度腰椎滑脱症的疗效观察. 中国脊柱脊髓杂志, 2009, 19(5):354-359.
5. Gille O, Jol ivet E, Dousset V, et al. Erector spine muscle changes on magnetic resonance imaging following lumbar surgery through a posterior approach. Spine (Phila Pa 1976), 2007, 32(11):1236-1241.
6. Motosuneya T, Asazuma T, Tsuji T, et al. Postoperative change of the cross-sectional area of back musculature after 5 surgical procedures as assessed by magnetic resonance imaging. J Spinal Discord Tech, 2006, 19(5):318-322.
7. 黎庆初, 尹刚辉, 张忠民, 等. 微创Wiltse入路与传统后正中入路手术治疗双节段腰椎管狭窄症的疗效比较. 中国脊柱脊髓杂志, 2012, 22(9):812-817.
8. Wang J, Zhou Y, Zhang ZF, et al. Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J, 2010, 19(10):1780-1784.
9. Hyun SJ, Kim YB, Kim YS, et al. Postoperative changes in paraspinal muscle volume:comparison between paramedian interfascial and midline approaches for lumbar fusion. Korean Med Sci, 2007, 22(4):646-651.
10. Levin DA, Hale JJ, Bendo JA. Adjacent segment degeneration following spinal fusion for degenerative disc disease. Bull NYU Hosp Jt Dis, 2007, 65(1):29-36.
11. Kim KT, Lee SH, Suk KS, et al. The quantitative analysis of tissue injury markers after mini-open lumbar fusion. Spine (Phila Pa 1976), 2006, 31(6):712-716.
12. 黎庆初, 胡辉林, 刘宝戈, 等. 多裂肌间隙入路微创手术治疗腰椎滑脱症. 中国脊柱脊髓杂志, 2011, 21(4):303-307.
13. 王建, 周跃, 张正丰, 等. 微创经椎间孔腰椎体间融合术治疗腰椎滑脱症的临床研究. 中华外科杂志, 2011, 49(12):1076-1080.
14. 滕海军, 王亮, 郭志良, 等. Quadrant通道下治疗退变性腰椎滑脱的临床疗效. 临床骨科杂志, 2012, 15(5):498-500.
15. Foley KT, Gupta SK, Justis JR, et al. Percutaneous pedicle screw fixation of the lumbar spine. Neurosurg Focus, 2001, 10(4):E10.
16. 王建, 周跃, 初同伟, 等. 改良内窥镜下行后路腰椎间融合和经皮椎弓根螺钉固定治疗腰椎退变性疾患. 中国脊柱脊髓杂志, 2007, 17(12):908-912.
17. 李立钧, 周炜, 陆晴友, 等. 微创经椎间孔腰椎间融合术治疗下腰椎疾患的初步报告. 中国修复重建外科杂志, 2008, 22(4):501-503.
18. 孟志斌, 李俊, 李洪潮, 等. X-TUBE内镜下椎弓根钉内固定治疗退行性腰椎管狭窄伴腰椎滑脱的近期临床观察. 颈腰痛杂志, 2008, 29(2):124-127.
19. 滕海军, 王亮, 郭志良, 等. Quadrant通道下单切口治疗腰椎滑脱近期疗效观察. 中国修复重建外科杂志, 2010, 24(5):517-520.
20. 钱济先, 李存孝, 龙华, 等. 微创通道结合经皮椎弓根螺钉固定治疗腰椎退变的个体化方案选择. 中国骨科临床与基础研究杂志, 2012, 4(5):325-331.
21. Poussa M, Remes V, Lamberg T, et al. Treatment of severe spondylol isthesis in adolescence with reduction of fusion in situ:long-term cl inical, radiologic, and functional outcome. Spine (Phila Pa 1976), 2006, 31(5):583-592.
22. Musacchio M, Patel N, Bagan B, et al. Minimally invasive lumbar laminectomy via a dual-tube technique:evaluation in a cadaver model. Surg Neurol, 2007, 67(4):348-352.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF TRANSFORAMINAL LUMBAR INTERBODY FUSION VIA Luxor RETRACTOR ASSOCIATED WITH Mantis PEDICLE SCREW IN TREATMENT OF MODERATE AND SEVERE LUMBAR SPONDYLOLISTHESIS

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