Contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral MIS-TLIF vs. open TLIF in the treatment of multi-segmental lumbar degenerative diseases: A five years retrospective study and finite element analysis
ObjectiveTo evaluate the efficacy, safety, feasibility and biomechanical stability of contralateral bridge fixation of freehand minimally invasive pedicle screws (Freehand MIPS) combined with unilateral minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF) (smile-face surgery)...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1049260/full |
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| author | Yingkai Zhang Yingkai Zhang Tianyao Zhou Tianyao Zhou Yutong Gu Yutong Gu Wu Che Liang Zhang Yichao Wang |
| author_facet | Yingkai Zhang Yingkai Zhang Tianyao Zhou Tianyao Zhou Yutong Gu Yutong Gu Wu Che Liang Zhang Yichao Wang |
| author_sort | Yingkai Zhang |
| collection | DOAJ |
| description | ObjectiveTo evaluate the efficacy, safety, feasibility and biomechanical stability of contralateral bridge fixation of freehand minimally invasive pedicle screws (Freehand MIPS) combined with unilateral minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF) (smile-face surgery) and open TLIF for the treatment of multi-segmental lumbar degenerative diseases (LDDs).MethodsFrom January 2013 to January 2016, clinical data of multi-segmental (2- or 3-level) LDDs receiving smile-face surgery or open TLIF were retrospectively collected and analyzed. The back and leg pain VAS and ODI were used to assess clinical outcomes preoperatively and postoperatively. The MacNab criteria were used to evaluate the satisfaction of patient. The disc height (DH), lumbar lordosis (LL) and segmental lordosis angle (SLA) were measured before and after surgery. We used patient's CT data to establish the finite element model of smile-face surgery and open TLIF, and analyze biomechanical stability of two methods.ResultsSmile-face surgery group showed shorter operation time, shorter incision, less blood loss, shorter hospital stay than open TLIF (P < 0.05). The back VAS in smile-face surgery group was significantly lower than that in open TLIF immediately and 3 months after surgery, and no significant difference was observed 1 year, 2 years and 5 years after surgery. There was no significant difference in the leg pain VAS and ODI between both groups after surgery. No significant difference was observed between two groups in the DH, LL and SLA. At 5-year follow-up, grade I or II fusion was achieved in 99.00% (100/101) segments of smile-face surgery group and 97.67% (84/86) segments of open TLIF group according to Bridwell system. The complication rate of open TLIF was higher than that of smile-face surgery (24.32% vs. 0%, P < 0.01). After verification, the established finite element model can accurately simulate the biological structure of lumbar spine and there was no significant difference in biomechanical stability between two methods.ConclusionsSmile-face surgery has some advantages over open TLIF including smaller aggression, less blood loss, and lower cost, indicating that it is a good choice of treatment for multi-segmental LDDs. Both methods can achieve good biomechanical stability. |
| first_indexed | 2024-04-12T17:28:09Z |
| format | Article |
| id | doaj.art-65d8eb60e53c4e73a5700de4d4a5dbfd |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-12T17:28:09Z |
| publishDate | 2022-11-01 |
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| series | Frontiers in Surgery |
| spelling | doaj.art-65d8eb60e53c4e73a5700de4d4a5dbfd2022-12-22T03:23:12ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-11-01910.3389/fsurg.2022.10492601049260Contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral MIS-TLIF vs. open TLIF in the treatment of multi-segmental lumbar degenerative diseases: A five years retrospective study and finite element analysisYingkai Zhang0Yingkai Zhang1Tianyao Zhou2Tianyao Zhou3Yutong Gu4Yutong Gu5Wu Che6Liang Zhang7Yichao Wang8Department of Orthopaedic Surgery, Zhongshan Hospital Fudan University, Shanghai, ChinaDepartment of Orthopaedic Surgery, Jinshan Hospital of Fudan University, Shanghai, ChinaDepartment of Orthopaedic Surgery, Zhongshan Hospital Fudan University, Shanghai, ChinaShanghai Southwest Spine Surgery Center, Shanghai, ChinaDepartment of Orthopaedic Surgery, Zhongshan Hospital Fudan University, Shanghai, ChinaShanghai Southwest Spine Surgery Center, Shanghai, ChinaDepartment of Orthopaedic Surgery, Zhongshan Hospital Fudan University, Shanghai, ChinaDepartment of Orthopaedic Surgery, Zhongshan Hospital Fudan University, Shanghai, ChinaDepartment of Orthopaedic Surgery, Zhongshan Hospital Fudan University, Shanghai, ChinaObjectiveTo evaluate the efficacy, safety, feasibility and biomechanical stability of contralateral bridge fixation of freehand minimally invasive pedicle screws (Freehand MIPS) combined with unilateral minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF) (smile-face surgery) and open TLIF for the treatment of multi-segmental lumbar degenerative diseases (LDDs).MethodsFrom January 2013 to January 2016, clinical data of multi-segmental (2- or 3-level) LDDs receiving smile-face surgery or open TLIF were retrospectively collected and analyzed. The back and leg pain VAS and ODI were used to assess clinical outcomes preoperatively and postoperatively. The MacNab criteria were used to evaluate the satisfaction of patient. The disc height (DH), lumbar lordosis (LL) and segmental lordosis angle (SLA) were measured before and after surgery. We used patient's CT data to establish the finite element model of smile-face surgery and open TLIF, and analyze biomechanical stability of two methods.ResultsSmile-face surgery group showed shorter operation time, shorter incision, less blood loss, shorter hospital stay than open TLIF (P < 0.05). The back VAS in smile-face surgery group was significantly lower than that in open TLIF immediately and 3 months after surgery, and no significant difference was observed 1 year, 2 years and 5 years after surgery. There was no significant difference in the leg pain VAS and ODI between both groups after surgery. No significant difference was observed between two groups in the DH, LL and SLA. At 5-year follow-up, grade I or II fusion was achieved in 99.00% (100/101) segments of smile-face surgery group and 97.67% (84/86) segments of open TLIF group according to Bridwell system. The complication rate of open TLIF was higher than that of smile-face surgery (24.32% vs. 0%, P < 0.01). After verification, the established finite element model can accurately simulate the biological structure of lumbar spine and there was no significant difference in biomechanical stability between two methods.ConclusionsSmile-face surgery has some advantages over open TLIF including smaller aggression, less blood loss, and lower cost, indicating that it is a good choice of treatment for multi-segmental LDDs. Both methods can achieve good biomechanical stability.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1049260/fulllumbar degenerative diseasemulti-segmenttransforaminal lumbar interbody fusionpedicle screw fixationminimally invasive surgery |
| spellingShingle | Yingkai Zhang Yingkai Zhang Tianyao Zhou Tianyao Zhou Yutong Gu Yutong Gu Wu Che Liang Zhang Yichao Wang Contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral MIS-TLIF vs. open TLIF in the treatment of multi-segmental lumbar degenerative diseases: A five years retrospective study and finite element analysis Frontiers in Surgery lumbar degenerative disease multi-segment transforaminal lumbar interbody fusion pedicle screw fixation minimally invasive surgery |
| title | Contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral MIS-TLIF vs. open TLIF in the treatment of multi-segmental lumbar degenerative diseases: A five years retrospective study and finite element analysis |
| title_full | Contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral MIS-TLIF vs. open TLIF in the treatment of multi-segmental lumbar degenerative diseases: A five years retrospective study and finite element analysis |
| title_fullStr | Contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral MIS-TLIF vs. open TLIF in the treatment of multi-segmental lumbar degenerative diseases: A five years retrospective study and finite element analysis |
| title_full_unstemmed | Contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral MIS-TLIF vs. open TLIF in the treatment of multi-segmental lumbar degenerative diseases: A five years retrospective study and finite element analysis |
| title_short | Contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral MIS-TLIF vs. open TLIF in the treatment of multi-segmental lumbar degenerative diseases: A five years retrospective study and finite element analysis |
| title_sort | contralateral bridge fixation of freehand minimally invasive pedicle screws combined with unilateral mis tlif vs open tlif in the treatment of multi segmental lumbar degenerative diseases a five years retrospective study and finite element analysis |
| topic | lumbar degenerative disease multi-segment transforaminal lumbar interbody fusion pedicle screw fixation minimally invasive surgery |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1049260/full |
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