Research Article
LOMBER DEJENERATİF HASTALIKLARDA LOMBER TRANSFORAMİNAL KORPUSLAR ARASI FÜZYON(TLIF) KAFESLERİNİN ANTERİORA DOĞRU YERLEŞTİRİLMESİ; RETROSPEKTİF ANALİZ Anterior Misplacement of Lumbar Transforaminal Interbody Fusion (TLIF) Cages in Lumbar Degenerative Disc Disease: A retrospective Analysis
Abstract
ÖZET
Amaç: Tek merkezde lomber dejeneratif hastalıklarda uygulanan lomber korpuslar arası füzyon kafeslerinin
(TLIF) anteriora (anterior longtdiunal ligamanı geçmiş şekilde) yerleştirilme sebeplerini ve oranlarını tanımlamak.
Yöntemler: 2014 -2017 yılları arasında 270 hasta ve bu hastaların 366 disk mesafesine uygulanan TLIF kafes
uygulaması incelendi. TLIF için uygulanan kafeslerin boyutuna ve uygulanış yerlerine göre erken operasyon
sonrası dönemde anterior yerleştirme oranlarına ve nedenlerine bakıldı.
Bulgular: Buna göre anteriora yerleştirme toplamda 3 hastada görüldü. Anteriora yerleştirme oranı tek merkezli
yapılan bu çalışmada %0.008 civarındadır. Bunlardan üçünde de anteriora yerleştirme seviyesinin L5-S1
seviyesi olduğu görüldü.
Bu hastalarda ve diğer hastalarda kullanılan kafeslerin boyutları da ele alındı. Boyutlar ele alındığında 3
hastada da disk mesafesinin ön arka çapının orta noktasının sagittal görüntüdeki yüksekliğinin kafes yüksekliğinden
daha fazla olduğu görüldü.
Sonuç: L5-S1 seviyesi diskin ön yüksekliği diğer disk mesafelerine göre daha fazla olduğu için burada kafesin
anteriora yerleştirilmesi olasılığı yüksektir. Bunu da diskin orta noktasındaki sagittal boyutundan daha büyük
bir kafes kullanılması önleyebilir.
Disk mesafesinin anteroposterior çapının orta noktasında geçen disk yüksekliğinin boyutundan daha küçük
bir boyuta sahip kafes uygulamasının, anteriora yerleşimi için bir risk olacağı sonucuna varılmıştır.
Anahtar Kelimeler: Öne doğru çıkma; Komplikasyon; TLIF
ABSTRACT
Aim: The aim of this study was to define the anterior misplacement rates and causes of lumbar transforaminal
interbody fusion (TLIF) cages applied in spinal degenerative diseases in a single center
Material-Method: Between 2014 and 2017, 366 intervertebral disc spaces in 270 patients which underwent
TLIF cages application were evaluated. The anterior misplacement rates and causes of cages applied for
fusion were assessed according to the size and location. All patients had lumbar degenerative diseases.
Cage were performed in all cases where instability was obvious or the foraminal height should be increased.
Peroperative scopy or early postoperative images were evaluated in the evaluation of anterior misplacement.
Postoperative computed tomography (CT) was performed in all patients.
The dimensions of the cages used in these patients and other patients were also discussed.
Results: According to this, anterior misplacement was seen in 3 patients in total. It was seen that the level
of misplacement was L5-S1 level in these three patients. Anterior misplacement rate is nearly 0.008% in this
study which carried out in a single center.
Conclusion: Since the frontmost height of the L5-S1 disc space is wider than the other disc spaces, the cage
is more likely to be applied in a misplacement location. Application of a larger cage than the sagittal height
of the midpoint of disc space can also prevent this. It was concluded that a cage application with a smaller
size than the size of height of the disc space crossing at the midpoint of anteroposterior diameter of the disc
space would be a risk for anterior misplacement.
Key Words: Antepulsion; Complication; TLIF
References
- 1. Schwender JD, Holly LT, Rouben DP, Foley KT. Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results. Clinical Spine Surgery 2005;18:1-6. 2. McAfee PC, DeVine JG, Chaput CD, Prybis BG, Fedder IL, Cunningham BW et al. The indications for interbody fusion cages in the treatment of spondylolisthesis: analysis of 120 cases. Spine 2005;30:60-5. 3. Hackenberg L, Halm H, Bullmann V, Vieth V, Schneider M, Liljenqvist U. Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results. European Spine Journal 2005;14:551-8. 4. Santos ER, Pinto MR, Lonstein JE, Denis F, Garvey TA, Perra JH et al. Revision lumbar arthrodesis for the treatment of lumbar cage pseudoarthrosis: complications. Clinical Spine Surgery 2008;21:418-21. 5. Mirovsky Y, Floman Y, Smorgick Y, Ashkenazi E, Anekstein Y, Millgram MA et al. Management of deep wound infection after posterior lumbar interbody fusion with cages. Clinical Spine Surgery 2007;20:127-31. 6. Elias WJ, Simmons NE, Kaptain GJ, Chadduck JB, Whitehill R. Complications of posterior lumbar interbody fusion when using a titanium threaded cage device. Journal of Neurosurgery: Spine 2000;93:45-52. 7. Villavicencio AT, Burneikiene S, Bulsara KR, Thramann JJ. Perioperative complications in transforaminal lumbar interbody fusion versus anterior–posterior reconstruction for lumbar disc degeneration and instability.Clinical Spine Surgery 2006;9:92-7. 8. Tormenti MJ, Maserati MB, Bonfield CM, Gerszten PC, Moossy JJ, Kanter AS et al. Perioperative surgical complications of transforaminal lumbar interbody fusion: a single-center experience. Journal of Neurosurgery: Spine 2012;16:44-50. 9. Ceylan D, Yaldiz C, Asil K, Kaçira T, Tatarli N, Can A. Intraoperative antepulsion of a posterior lumbar interbody fusion cage: three case reports. The Pan African medical journal 2015;20. 10. Proubasta IR, Vallvé EQ, Aguilar LF, Villanueva CL, Iglesias JJ. Intraoperative antepulsion of a fusion cage in posterior lumbar interbody fusion: a case report and review of the literature. Spine 2002;27:399-402.
Year 2019,
Volume: 9 Issue: 2, 1 - 5, 28.06.2019
Abstract
References
- 1. Schwender JD, Holly LT, Rouben DP, Foley KT. Minimally invasive transforaminal lumbar interbody fusion (TLIF): technical feasibility and initial results. Clinical Spine Surgery 2005;18:1-6. 2. McAfee PC, DeVine JG, Chaput CD, Prybis BG, Fedder IL, Cunningham BW et al. The indications for interbody fusion cages in the treatment of spondylolisthesis: analysis of 120 cases. Spine 2005;30:60-5. 3. Hackenberg L, Halm H, Bullmann V, Vieth V, Schneider M, Liljenqvist U. Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results. European Spine Journal 2005;14:551-8. 4. Santos ER, Pinto MR, Lonstein JE, Denis F, Garvey TA, Perra JH et al. Revision lumbar arthrodesis for the treatment of lumbar cage pseudoarthrosis: complications. Clinical Spine Surgery 2008;21:418-21. 5. Mirovsky Y, Floman Y, Smorgick Y, Ashkenazi E, Anekstein Y, Millgram MA et al. Management of deep wound infection after posterior lumbar interbody fusion with cages. Clinical Spine Surgery 2007;20:127-31. 6. Elias WJ, Simmons NE, Kaptain GJ, Chadduck JB, Whitehill R. Complications of posterior lumbar interbody fusion when using a titanium threaded cage device. Journal of Neurosurgery: Spine 2000;93:45-52. 7. Villavicencio AT, Burneikiene S, Bulsara KR, Thramann JJ. Perioperative complications in transforaminal lumbar interbody fusion versus anterior–posterior reconstruction for lumbar disc degeneration and instability.Clinical Spine Surgery 2006;9:92-7. 8. Tormenti MJ, Maserati MB, Bonfield CM, Gerszten PC, Moossy JJ, Kanter AS et al. Perioperative surgical complications of transforaminal lumbar interbody fusion: a single-center experience. Journal of Neurosurgery: Spine 2012;16:44-50. 9. Ceylan D, Yaldiz C, Asil K, Kaçira T, Tatarli N, Can A. Intraoperative antepulsion of a posterior lumbar interbody fusion cage: three case reports. The Pan African medical journal 2015;20. 10. Proubasta IR, Vallvé EQ, Aguilar LF, Villanueva CL, Iglesias JJ. Intraoperative antepulsion of a fusion cage in posterior lumbar interbody fusion: a case report and review of the literature. Spine 2002;27:399-402.
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Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Original Research |
| Authors | |
| Publication Date | June 28, 2019 |
| Published in Issue | Year 2019 Volume: 9 Issue: 2 |
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