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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2022; 41(04): e335-e339
DOI: 10.1055/s-0041-1740167
Original Article

Study on Outcome Analysis of Transforaminal Interbody Fusion with Transpedicular Screws and Rods in Lumbar Spondylolisthesis and Spondylolysis

Estudo sobre análise de resultados de fusão intersomática transforaminal com parafusos e hastes transpediculares na espondilolistese e espondilólise lombar
Prakash Mahantshetti 
1   Department of Neurosurgery, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
,
Prasad Soraganvi 
2   Department of Orthopedics, P.E.S. Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
,
Rayadurg Palegar Raghavendra Raju 
3   Department of Orthopedics, MS Naidu Hospital, Vijayawada, Andhra Pradesh, India
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Abstract

Introduction The management of spondylolisthesis and spondylolysis is primarily conservative or surgical. There are various surgical procedures available for spondylolisthesis.

Objective To evaluate the functional outcome and efficacy in patients undergoing transforaminal lumbar interbody fusion with transpedicular screws and rods in symptomatic lumbar spondylolisthesis and spondylolysis.

Methods From 2017 to 2018, a prospective observational study was performed in a tertiary care hospital. The preoperative evaluation was performed both clinically and radiologically. Based on indications, transforaminal interbody fusion was performed. A total sample of 20 patients was included. The primary outcome variables were the visual analogue scale (VAS), the Oswestry Disability Index (ODI), slip percentage, and disc height at follow-up. For the statistical analysis, coGuide (BDSS CORP, Bangalore, Karnataka, India) was used.

Results In 20 participants studied, the mean age was 48.25 ± 5.35 years old. Degenerative spondylolisthesis was seen in 60% of the participants. The majority (70%) of the patients had grade 2 slips. The mean difference of the VAS, the ODI, slip percentage, and disc height between the preoperative and postoperative periods was statistically significant (p < 0.001). The majority (70%) of the patients had no complications after the procedure.

Conclusions Transforaminal interbody fusion with pedicle screws and rods is a safe, simple procedure and has less morbidity. This procedure also provides better functional outcomes and reduction in symptoms by maintaining the disc height and providing sagittal balance.

Resumo

Introdução O tratamento da espondilolistese e espondilólise é principalmente conservador ou cirúrgico. Existem vários procedimentos cirúrgicos disponíveis para espondilolistese.

Objetivo Avaliar o resultado funcional e a eficácia em pacientes submetidos a fusão intersomática lombar transforaminal com parafusos e hastes transpediculares em espondilolistese e espondilólise lombar sintomática.

Métodos De 2017 a 2018, foi realizado um estudo observacional prospectivo em um hospital terciário. A avaliação pré-operatória foi feita clínica e radiologicamente. Com base nas indicações, a fusão intersomática transforaminal foi feita. Uma amostra total de 20 pacientes foi incluída. As variáveis de desfecho primárias foram a escala visual analógica (EVA), o Oswestry Disability Index (ODI, na sigla em inglês), porcentagem de escorregamento e altura do disco no acompanhamento. Para análise estatística, foi utilizado o coGuide (BDSS CORP, Bangalore, Karnataka, índia).

Resultados Nos 20 participantes estudados, a média de idade foi de 48,25 ± 5,35 anos. Espondilolistese degenerativa foi observada em 60% dos participantes. A maioria (70%) dos pacientes apresentou deslizamentos de grau 2. A diferença média da EVA, do ODI, da porcentagem de escorregamento e da altura do disco entre os períodos pré- e pós-operatório foi estatisticamente significativa (p < 0,001). A maioria (70%) dos pacientes não apresentou complicações após o procedimento.

Conclusões A fusão intersomática transforaminal com parafusos pediculares e hastes é um procedimento seguro, simples e de menor morbidade. Este procedimento também fornece melhores resultados funcionais e redução dos sintomas, mantendo a altura do disco e proporcionando equilíbrio sagital.

Keywords

spondylolisthesis - spondylolysis - intervertebral disc degeneration

Palavras-chave

espondilolistese - espondilólise - degeneração do disco intervertebral


Publication History

Received: 30 May 2021

Accepted: 06 September 2021

Article published online:
08 June 2022

© 2022. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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