Clin Surg | Volume 7, Issue 1 | Research Article | Open Access

Comparison of Two Extended Interbody Fusion Techniques in the Treatment of Adjacent Segment Disease after Transforaminal Lumbar Interbody Fusion: Using Cortical Bone Trajectory Screws vs. Traditional Pedicle Screws Combined with a Novel Domino System

Xin Song1, Donglin Ren1, Shuai Han1, Desheng Wu2 and Jian Wang1*

1Department of Orthopedics, Pudong New District Peoples’ Hospital, Shanghai, China
2Department of Spine Surgery, Shanghai East Hospital affiliated to Tongji University, Shanghai, China

*Correspondance to: Jian Wang 

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Abstract

Objective: To illustrate two minimally invasive extended interbody fusion techniques using Cortical Bone Trajectory screws with Posterior Lumbar Interbody Fusion (CBT-PLIF) and Traditional Pedicle Screws and a Domino System with Transforaminal Lumbar Interbody Fusion (TPSDomino- TLIF) for Adjacent Segment Disease (ASD) after lumbar fusion surgery, and compare the postoperative radiographic and clinical outcomes between the both techniques for ASD. Methods: A retrospective study including 72 patients was conducted in this study, 32 patients received CBT-PLIF and the other 40 patients received TPS-Domino-TLIF. Patient demographics, surgical data, complications, radiologic and clinical outcomes were evaluated and compared between the two groups. Results: There was significantly shorter surgical duration, as well as less Estimated Blood Loss (EBL) and a lower frequency of intra-operative fluoroscopy, in TPS-Domino-TLIF when compared with CBT-PLIF (p<0.05). The lumbar lordotic angle was improved both at immediate post-operation (p=0.006) and the last follow-up (p=0.007) in TPS-Domino-TLIF group as compared with CBTPLIF group. The larger mean inter-vertebral height in TPS-Domino-TLIF group was observed than that in CBT-PLIF group at immediate post-operation (p=0.007) and the last follow-up (p=0.005). The clinical outcomes containing the mean VAS-back, VAS-leg and ODI were improved significantly postoperatively in both groups. Conclusion: Advantaged by shorter surgical duration, less Estimated Blood Loss (EBL), a lower frequency of intra-operative fluoroscopy, and superior radiological outcomes, TPS-Domino-TLIF could be considered a viable alternative to the midline fusion technique using CBT for ASD.

Keywords:

ASD; Lumbar fusion; Traditional pedicle screws; CBT

Citation:

Song X, Ren D, Han S, Wu D, Wang J. Comparison of Two Extended Interbody Fusion Techniques in the Treatment of Adjacent Segment Disease after Transforaminal Lumbar Interbody Fusion: Using Cortical Bone Trajectory Screws vs. Traditional Pedicle Screws Combined with a Novel Domino System. Clin Surg. 2022; 7: 3409..

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