Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)

Shafik Tahseen El Molla; Hisham Anwer; Hatem Sabry

doi:doi:10.11648/j.ijn.20200402.13

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Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)

Shafik Tahseen El Molla, Hisham Anwer, Hatem Sabry

Published in International Journal of Neurosurgery (Volume 4, Issue 2)

Received: 22 June 2020 Accepted: 25 July 2020 Published: 10 August 2020

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Abstract

Introduction: Lumbar degenerative diseases (LDD) is considered a common disease. Lumbar pedicular screw fixation and interbody fusion is one of the com¬monly used and effective surgical method in management of single-level lumbar degenerative diseases. Although bilateral pedicular screw (PS) fixation after lumbar interbody fusion is accepted as a standard surgical procedure providing rigid fixation with a great biomechanical stability and clinical benefits, the rigidity of bilateral (PS) fixation can cause device-related osteoporosis of the vertebrae which makes the adjacent segment prone to load and motion-induced degeneration. Therefore, the concept of using less rigid systems of fixation has been advocated. Aim of study: To evaluate effectiveness of unilateral pedicular screws fixation and interbody fusion in unilateral degenerative spine pathology. Patients and methods: This study included 34 patients with single level degenerative lumbar spine disease who were subjected to transforaminal interbody lumbar fusion (TILF) and unilateral transpedicular screws fixation between July 2017 and March 2019 in Ain Shams University hospitals. Results: The study was conducted on 34 patients with age ranging between 32-56 years (mean 45.12±7.80 years). There were 17 male and 17 female in this study. When comparing VAS back pain preoperatively and at postoperative intervals of 1,6 and 12 months, it showed highly significant improvement (P-value 0.000). Also when comparing VAS of leg pain preoperatively and at postoperative intervals of 1,6 and 12 months duration, it showed highly significant improvement (P-value 0.000). ODI preoperatively and at postoperative intervals of 1,6 and 12 months showed also highly significant improvement (P-value 0.000). Regarding the fusion rate, at 6 months postoperative 61.8% (21) of the patients had fusion grade 1,26.5% (9) of the patients had fusion grade 2 and 11.8% (4) of the patients had fusion grade 3. While at 12 months postoperative the percent of grade 1 fusion increased to become 85.3% (29 patients) and the rest were grade 2 fusions (14.7%) with no patients with grade 3 fusion. Conclusion: Unilateral pedicular screws and interbody fusion is a good modality of treatment for unilateral degenerative spine pathology.

Published in	International Journal of Neurosurgery (Volume 4, Issue 2)
DOI	10.11648/j.ijn.20200402.13
Page(s)	34-40
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Lumbar Fixation, Unilateral, Interbody Cage Fusion, Degenerative Lumbar Spine

References

[1]	Huan Liu, Ying Xu, Si-Dong Yang, Tao Wang, Hui Wang, Feng-Yu Liu, Wen-Yuan Ding: Unilateral versus bilateral pedicle screw fixation with posterior lumbar interbody fusion for lumbar degenerative diseases A meta-analysis. Medicine, 96: 21 (e6882), 2017.
[2]	Si-Dong Yang, Qian Chen, Wen-Yuan Ding, Jian-Qiang Zhao, Ying-Ze Zhang, Yong Shen, Da-Long Yang: Unilateral Pedicle Screw Fixation with Bone Graft vs. Bilateral Pedicle Screw Fixation with Bone Graft or Cage: A Comparative Study, Med Sci Monit; 22: 890-897, 2016.
[3]	Liu Z, Fei Q, Wang B, Lv P, Chi C, Yang Y, Zhao F, Lin J, Ma Z.: A meta-analysis of unilateral versus bilateral pedicle screw fixation in minimally invasive lumbar interbody fusion. PLoS One. 6; 9 (11): e111979, 2014.
[4]	Chen DJ, Yao C, Song Q, Tang B, Liu X, Zhang B, Dai M, Nie T, Wan Z.: Unilateral versus Bilateral Pedicle Screw Fixation Combined with Transforaminal Lumbar Interbody Fusion for the Treatment of Low Lumbar Degenerative Disc Diseases: Analysis of Clinical and Radiographic Results. World Neurosurg; 115: e516-e522, 2018.
[5]	Kai Z, Wei S, Chang-qing Z, Hua L, Wei D, You-zhuan X, Xiao-jiang S, Jie Z.: Unilateral versus bilateral instrumented transforaminal lumbar interbody fusion in two-level degenerative lumbar disorders: a prospective randomised study. International orthopaedics.; 38 (1): 111-6, 2014.
[6]	Işik HS, Okutan Ö, Yildirim T, Akpinar E, Yilmaz A.: Comparison of Unilateral versus Bilateral Pedicle Screw Fixation in Transforaminal Lumbar Interbody Fusion for Single Level Lumbar Degenerative Diseases and Review of Literature. Turk Neurosurg, vol. 28, no. 5, 731-739, 2018.
[7]	Shen X, Wang L, Zhang H, Gu X, Gu G, He S.: Radiographic Analysis of One-level Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF) With Unilateral Pedicle Screw Fixation for Lumbar Degenerative Diseases. Clin Spine Surg.; 29 (1): E1-8, 2016.
[8]	Dahdaleh NS, Nixon AT, Lawton CD, Wong AP, Smith ZA, Fessler RG.: Outcome following unilateral versus bilateral instrumentation in patients undergoing minimally invasive transforaminal lumbar interbody fusion: a single-center randomized prospective study. Neurosurg Focus. Aug; 35 (2): E13, 2013.
[9]	Villavicencio AT, Serxner BJ, Mason A, Nelson EL, Rajpal S, Faes N, Burneikiene S.: Unilateral and bilateral pedicle screw fixation in transforaminal lumbar interbody fusion: radiographic and clinical analysis. World Neurosurg; 83 (4): 553-9, 2015.
[10]	Yang X, Wang H, Zhao Q, Xu H, Liu P, Jin Y.: A comparison of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion for lumbar degenerative diseases. Chin Med J (Engl); 127 (20): 3592-6, 2014.
[11]	Aoki Y, Yamagata M, Ikeda Y, Nakajima F, Ohtori S, Nakagawa K, Nakajima A, Toyone T, Orita S, Takahashi K.: A prospective randomized controlled study comparing transforaminal lumbar interbody fusion techniques for degenerative spondylolisthesis: unilateral pedicle screw and 1 cage versus bilateral pedicle screws and 2 cages. J Neurosurg Spine; 17 (2): 153-9, 2012.
[12]	Xue H, Tu Y, Cai M.: Comparison of unilateral versus bilateral instrumented transforaminal lumbar interbody fusion in degenerative lumbar diseases. Spine J.; 12 (3): 209-15, 2012.

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APA Style

Shafik Tahseen El Molla, Hisham Anwer, Hatem Sabry. (2020). Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome). International Journal of Neurosurgery, 4(2), 34-40. https://doi.org/10.11648/j.ijn.20200402.13

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ACS Style

Shafik Tahseen El Molla; Hisham Anwer; Hatem Sabry. Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome). Int. J. Neurosurg. 2020, 4(2), 34-40. doi: 10.11648/j.ijn.20200402.13

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AMA Style

Shafik Tahseen El Molla, Hisham Anwer, Hatem Sabry. Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome). Int J Neurosurg. 2020;4(2):34-40. doi: 10.11648/j.ijn.20200402.13

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@article{10.11648/j.ijn.20200402.13,
  author = {Shafik Tahseen El Molla and Hisham Anwer and Hatem Sabry},
  title = {Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)},
  journal = {International Journal of Neurosurgery},
  volume = {4},
  number = {2},
  pages = {34-40},
  doi = {10.11648/j.ijn.20200402.13},
  url = {https://doi.org/10.11648/j.ijn.20200402.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20200402.13},
  abstract = {Introduction: Lumbar degenerative diseases (LDD) is considered a common disease. Lumbar pedicular screw fixation and interbody fusion is one of the com¬monly used and effective surgical method in management of single-level lumbar degenerative diseases. Although bilateral pedicular screw (PS) fixation after lumbar interbody fusion is accepted as a standard surgical procedure providing rigid fixation with a great biomechanical stability and clinical benefits, the rigidity of bilateral (PS) fixation can cause device-related osteoporosis of the vertebrae which makes the adjacent segment prone to load and motion-induced degeneration. Therefore, the concept of using less rigid systems of fixation has been advocated. Aim of study: To evaluate effectiveness of unilateral pedicular screws fixation and interbody fusion in unilateral degenerative spine pathology. Patients and methods: This study included 34 patients with single level degenerative lumbar spine disease who were subjected to transforaminal interbody lumbar fusion (TILF) and unilateral transpedicular screws fixation between July 2017 and March 2019 in Ain Shams University hospitals. Results: The study was conducted on 34 patients with age ranging between 32-56 years (mean 45.12±7.80 years). There were 17 male and 17 female in this study. When comparing VAS back pain preoperatively and at postoperative intervals of 1,6 and 12 months, it showed highly significant improvement (P-value 0.000). Also when comparing VAS of leg pain preoperatively and at postoperative intervals of 1,6 and 12 months duration, it showed highly significant improvement (P-value 0.000). ODI preoperatively and at postoperative intervals of 1,6 and 12 months showed also highly significant improvement (P-value 0.000). Regarding the fusion rate, at 6 months postoperative 61.8% (21) of the patients had fusion grade 1,26.5% (9) of the patients had fusion grade 2 and 11.8% (4) of the patients had fusion grade 3. While at 12 months postoperative the percent of grade 1 fusion increased to become 85.3% (29 patients) and the rest were grade 2 fusions (14.7%) with no patients with grade 3 fusion. Conclusion: Unilateral pedicular screws and interbody fusion is a good modality of treatment for unilateral degenerative spine pathology.},
 year = {2020}
}

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TY  - JOUR
T1  - Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)
AU  - Shafik Tahseen El Molla
AU  - Hisham Anwer
AU  - Hatem Sabry
Y1  - 2020/08/10
PY  - 2020
N1  - https://doi.org/10.11648/j.ijn.20200402.13
DO  - 10.11648/j.ijn.20200402.13
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 34
EP  - 40
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20200402.13
AB  - Introduction: Lumbar degenerative diseases (LDD) is considered a common disease. Lumbar pedicular screw fixation and interbody fusion is one of the com¬monly used and effective surgical method in management of single-level lumbar degenerative diseases. Although bilateral pedicular screw (PS) fixation after lumbar interbody fusion is accepted as a standard surgical procedure providing rigid fixation with a great biomechanical stability and clinical benefits, the rigidity of bilateral (PS) fixation can cause device-related osteoporosis of the vertebrae which makes the adjacent segment prone to load and motion-induced degeneration. Therefore, the concept of using less rigid systems of fixation has been advocated. Aim of study: To evaluate effectiveness of unilateral pedicular screws fixation and interbody fusion in unilateral degenerative spine pathology. Patients and methods: This study included 34 patients with single level degenerative lumbar spine disease who were subjected to transforaminal interbody lumbar fusion (TILF) and unilateral transpedicular screws fixation between July 2017 and March 2019 in Ain Shams University hospitals. Results: The study was conducted on 34 patients with age ranging between 32-56 years (mean 45.12±7.80 years). There were 17 male and 17 female in this study. When comparing VAS back pain preoperatively and at postoperative intervals of 1,6 and 12 months, it showed highly significant improvement (P-value 0.000). Also when comparing VAS of leg pain preoperatively and at postoperative intervals of 1,6 and 12 months duration, it showed highly significant improvement (P-value 0.000). ODI preoperatively and at postoperative intervals of 1,6 and 12 months showed also highly significant improvement (P-value 0.000). Regarding the fusion rate, at 6 months postoperative 61.8% (21) of the patients had fusion grade 1,26.5% (9) of the patients had fusion grade 2 and 11.8% (4) of the patients had fusion grade 3. While at 12 months postoperative the percent of grade 1 fusion increased to become 85.3% (29 patients) and the rest were grade 2 fusions (14.7%) with no patients with grade 3 fusion. Conclusion: Unilateral pedicular screws and interbody fusion is a good modality of treatment for unilateral degenerative spine pathology.
VL  - 4
IS  - 2
ER  -

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Author Information

Shafik Tahseen El Molla

Neurosurgery Department, Ain Shams University, Cairo, Egypt
Hisham Anwer

Neurosurgery Department, Ain Shams University, Cairo, Egypt
Hatem Sabry

Neurosurgery Department, Ain Shams University, Cairo, Egypt

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APA Style

Shafik Tahseen El Molla, Hisham Anwer, Hatem Sabry. (2020). Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome). International Journal of Neurosurgery, 4(2), 34-40. https://doi.org/10.11648/j.ijn.20200402.13

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ACS Style

Shafik Tahseen El Molla; Hisham Anwer; Hatem Sabry. Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome). Int. J. Neurosurg. 2020, 4(2), 34-40. doi: 10.11648/j.ijn.20200402.13

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AMA Style

Shafik Tahseen El Molla, Hisham Anwer, Hatem Sabry. Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome). Int J Neurosurg. 2020;4(2):34-40. doi: 10.11648/j.ijn.20200402.13

Copy | Download

@article{10.11648/j.ijn.20200402.13,
  author = {Shafik Tahseen El Molla and Hisham Anwer and Hatem Sabry},
  title = {Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)},
  journal = {International Journal of Neurosurgery},
  volume = {4},
  number = {2},
  pages = {34-40},
  doi = {10.11648/j.ijn.20200402.13},
  url = {https://doi.org/10.11648/j.ijn.20200402.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20200402.13},
  abstract = {Introduction: Lumbar degenerative diseases (LDD) is considered a common disease. Lumbar pedicular screw fixation and interbody fusion is one of the com¬monly used and effective surgical method in management of single-level lumbar degenerative diseases. Although bilateral pedicular screw (PS) fixation after lumbar interbody fusion is accepted as a standard surgical procedure providing rigid fixation with a great biomechanical stability and clinical benefits, the rigidity of bilateral (PS) fixation can cause device-related osteoporosis of the vertebrae which makes the adjacent segment prone to load and motion-induced degeneration. Therefore, the concept of using less rigid systems of fixation has been advocated. Aim of study: To evaluate effectiveness of unilateral pedicular screws fixation and interbody fusion in unilateral degenerative spine pathology. Patients and methods: This study included 34 patients with single level degenerative lumbar spine disease who were subjected to transforaminal interbody lumbar fusion (TILF) and unilateral transpedicular screws fixation between July 2017 and March 2019 in Ain Shams University hospitals. Results: The study was conducted on 34 patients with age ranging between 32-56 years (mean 45.12±7.80 years). There were 17 male and 17 female in this study. When comparing VAS back pain preoperatively and at postoperative intervals of 1,6 and 12 months, it showed highly significant improvement (P-value 0.000). Also when comparing VAS of leg pain preoperatively and at postoperative intervals of 1,6 and 12 months duration, it showed highly significant improvement (P-value 0.000). ODI preoperatively and at postoperative intervals of 1,6 and 12 months showed also highly significant improvement (P-value 0.000). Regarding the fusion rate, at 6 months postoperative 61.8% (21) of the patients had fusion grade 1,26.5% (9) of the patients had fusion grade 2 and 11.8% (4) of the patients had fusion grade 3. While at 12 months postoperative the percent of grade 1 fusion increased to become 85.3% (29 patients) and the rest were grade 2 fusions (14.7%) with no patients with grade 3 fusion. Conclusion: Unilateral pedicular screws and interbody fusion is a good modality of treatment for unilateral degenerative spine pathology.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)
AU  - Shafik Tahseen El Molla
AU  - Hisham Anwer
AU  - Hatem Sabry
Y1  - 2020/08/10
PY  - 2020
N1  - https://doi.org/10.11648/j.ijn.20200402.13
DO  - 10.11648/j.ijn.20200402.13
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 34
EP  - 40
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20200402.13
AB  - Introduction: Lumbar degenerative diseases (LDD) is considered a common disease. Lumbar pedicular screw fixation and interbody fusion is one of the com¬monly used and effective surgical method in management of single-level lumbar degenerative diseases. Although bilateral pedicular screw (PS) fixation after lumbar interbody fusion is accepted as a standard surgical procedure providing rigid fixation with a great biomechanical stability and clinical benefits, the rigidity of bilateral (PS) fixation can cause device-related osteoporosis of the vertebrae which makes the adjacent segment prone to load and motion-induced degeneration. Therefore, the concept of using less rigid systems of fixation has been advocated. Aim of study: To evaluate effectiveness of unilateral pedicular screws fixation and interbody fusion in unilateral degenerative spine pathology. Patients and methods: This study included 34 patients with single level degenerative lumbar spine disease who were subjected to transforaminal interbody lumbar fusion (TILF) and unilateral transpedicular screws fixation between July 2017 and March 2019 in Ain Shams University hospitals. Results: The study was conducted on 34 patients with age ranging between 32-56 years (mean 45.12±7.80 years). There were 17 male and 17 female in this study. When comparing VAS back pain preoperatively and at postoperative intervals of 1,6 and 12 months, it showed highly significant improvement (P-value 0.000). Also when comparing VAS of leg pain preoperatively and at postoperative intervals of 1,6 and 12 months duration, it showed highly significant improvement (P-value 0.000). ODI preoperatively and at postoperative intervals of 1,6 and 12 months showed also highly significant improvement (P-value 0.000). Regarding the fusion rate, at 6 months postoperative 61.8% (21) of the patients had fusion grade 1,26.5% (9) of the patients had fusion grade 2 and 11.8% (4) of the patients had fusion grade 3. While at 12 months postoperative the percent of grade 1 fusion increased to become 85.3% (29 patients) and the rest were grade 2 fusions (14.7%) with no patients with grade 3 fusion. Conclusion: Unilateral pedicular screws and interbody fusion is a good modality of treatment for unilateral degenerative spine pathology.
VL  - 4
IS  - 2
ER  -

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