SHORT-TERM EFFECTIVENESS OF INTERLAMINAR LUMBAR INSTRUMENTED FUSION THROUGH A SMALL INCISION FOR LUMBAR SPINAL STENOSIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

1Department of Orthopedics, Baoji Hospital of Traditional Chinese Medicine, Baoji Shaanxi, 721003, P.R.China;;
2Department of Neurological Surgery, William Beaumont School of Medicine, Oakland University, Royal Oak, MI 48073 USA.;

Corresponding author：

Keywords：

Lumbar spinal stenosis; Laminectomy and decompression; Interlaminar lumbar instrumented fusion

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Objective To evaluate the short-term effectiveness of local laminectomy and interlaminar lumbar instrumented fusion (ILIF) through a small incision for lumbar spinal stenosis. Methods Between November 2009 and January 2011, 16 patients with lumbar spinal stenosis were treated by local laminectomy and ILIF through a small incision. There
were 7 males and 9 females with an average age of 52.8 years (range, 49-67 years). Sixteen patients had lumbar degenerative stenosis with an average disease duration of 4 years and 7 months (range, 2 years-9 years and 4 months). Four cases complicated by lateral recessus stenosis, 3 by lumbar disc herniation. Involved segments included L3, 4 in 2 cases, L4, 5 in 4 cases, L5, S1 in 4 cases, L3, 4 and L4, 5 (double segments) in 2 cases, L4, 5 and L5, S1 (double segments) in 4 cases. The effectiveness was evaluated with the pre- and post-operative Visual Analogue Scale (VAS) scores, Oswestry Disabil ity Index (ODI). The cross-sectional areas of spinal canal were measured by CT scanning and were compared between pre- and post-operation. Results The average operative time was 47 minutes (range, 35-80 minutes); the average blood loss was 145 mL (range, 120-350 mL); and the average hospital ization days were 7.8 days (range, 4-15 days). Cerebrospinal fluid leakage occurred in 1 case, and healing of incisions by first intention was achieved in the others. The patients were followed up 12-22 months (mean, 14.8 months). CT scanning showed interspinous fusion in 14 cases and possible fusion in 2 cases after operation, with an average fusion time of 4.6 months
(range, 3-10 months). The postoperative VAS score, ODI, and cross-sectional area were significantly improved when compared with preoperative values (P lt; 0.05). Conclusion The ILIF can promote fusion between spinous processes, provide spine stabil ization, and protect the spinal cord. The procedure has small incision, simple method of fixation and fusion.

Citation： WANG Shaofei,CHAO Jianhu,WEI Jianmin,Fernando G,Diaz. SHORT-TERM EFFECTIVENESS OF INTERLAMINAR LUMBAR INSTRUMENTED FUSION THROUGH A SMALL INCISION FOR LUMBAR SPINAL STENOSIS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(6): 703-707. doi: Copy

1.	Aykaç B, Copuroğlu C, Ozcan M, et al. Postoperative evaluation of quality of life in lumbar spinal stenosis patients following instrumented posterior decompression. Acta Orthop Traumatol Turc, 2011, 45(1): 47-52.
2.	Slätis P, Malmivaara A, Heliovaara M, et al. Long-term results of surgery for lumbar spinal stenosis: a randomised controlled trial. Eur Spine J, 2011, 20(7): 1174-1181.
3.	Hansraj KK, O’Lcary PF, Cammisa FP Jr, et al. Decompression, fusion and instrumentation surgery for complex lumber spinal stenosis. Clin Orthop Relat Res, 2001, (348): 18-25.
4.	Hyun Bae MD. Evaluation of Interlaminar Lumbar Instrumented Fusion (ILIF) in a Sheep Model. 27th Annual meeting of the AANS/CNS, Phoenix: 2011.
5.	Genevay S, Chevallier-Ruggeri P, Faundez A, et al. The lumbar spinal stenosis: clinical, pathophysiology and treatment. Rev Med Suisse, 2012, 8(332): 585-586, 588-589.
6.	Yukawa Y, Lenke LG, Tenhula J, et al. A comprehensive study of patients with surgically treated lumbar spinal stenosis with neurogenic diration. J Bone Joint Surg (Br), 2002, 84-A(11): 1954-1959.
7.	Carreon LY, Glassman SD, Howard J. Fusion and nonsurgical treatment for symptomatic lumbar degenerative disease: a systematic review of Oswestry Disability Index and MOS Short Form-36 outcomes. Spine J, 2008, 8(5): 747-755.
8.	Bowers C, Amini A, Dailey AT, et al. Dynamic interspinous process stabilization: review of complications associated with the X-Stop device. Neurosurg Focus, 2010, 28(6): E8.
9.	Christie SD, Song JK, Fessler RG. Dynamic interspinous process technology. Spine (Phila Pa 1976), 2005, 30(16 Suppl): S73-78.
10.	Phillips FM, Voronov LI, Gaitanis IN, et al. Biomechanics of posterior dynamic stabilizing device (DIAM) after facetectomy and discectomy. Spine J, 2006, 6(6): 714-722.
11.	Tamburrelli FC, Proietti L, Logroscino CA. Critical analysis of lumbar interspinous devices failures: a retrospective study. Eur Spine J, 2011, 20 Supp1 1: S27-35.
12.	Lee DY, Lee SH, Shim CS, et al. Decompression and interspinous dynamic stabilization using the locker for lumbar canal stenosis associated with low-grade degenerative spondylolisthesis. Minim Invasive Neurosurg, 2010, 53(3): 117-121.
13.	Siepe CJ, Heider F, Beisse R, et al. Treatment of dynamic spinal canal stenosis with an interspinous spacer. Oper Orthop Traumatol, 2010, 22(5-6): 524-535.
14.	孙浩林, 李淳德, 刘宪义, 等. 棘突间固定系统与融合固定系统联合应用治疗腰椎退变性疾患. 中华外科杂志, 2010, 48(5): 363-367.
15.	王欢, 崔少千, 王海义, 等. 重建椎管后部结构治疗腰椎管狭窄症. 中国修复重建外科杂志, 2005, 19(12): 982-985.
16.	Fransen P. Prevention of scar tissue formation in spinal surgery: state of the art and review of the literature. J Neurosurg Sci, 2011, 55(3): 277-281.
17.	Fransen P. Reduction of postoperative pain after lumbar microdiscectomy with DuraSeal Xact Adhesion Barrier and Sealant System. Spine J, 2010, 10(9): 751-761.
18.	王洪伟, 阮美树, 孙连星, 等. “天窗式”责任节段整块椎板切除减压固定融合治疗复杂性腰椎管狭窄症. 中国矫形外科杂志, 2011, 19(7): 611-612.
19.	Chen E, Tong KB, Laouri M. Surgical treatment patterns among Medicare beneficiaries newly diagnosed with lumbar spinal stenosis. Spine J, 2010, 10(7): 588-594.

1. Aykaç B, Copuroğlu C, Ozcan M, et al. Postoperative evaluation of quality of life in lumbar spinal stenosis patients following instrumented posterior decompression. Acta Orthop Traumatol Turc, 2011, 45(1): 47-52.
2. Slätis P, Malmivaara A, Heliovaara M, et al. Long-term results of surgery for lumbar spinal stenosis: a randomised controlled trial. Eur Spine J, 2011, 20(7): 1174-1181.
3. Hansraj KK, O’Lcary PF, Cammisa FP Jr, et al. Decompression, fusion and instrumentation surgery for complex lumber spinal stenosis. Clin Orthop Relat Res, 2001, (348): 18-25.
4. Hyun Bae MD. Evaluation of Interlaminar Lumbar Instrumented Fusion (ILIF) in a Sheep Model. 27th Annual meeting of the AANS/CNS, Phoenix: 2011.
5. Genevay S, Chevallier-Ruggeri P, Faundez A, et al. The lumbar spinal stenosis: clinical, pathophysiology and treatment. Rev Med Suisse, 2012, 8(332): 585-586, 588-589.
6. Yukawa Y, Lenke LG, Tenhula J, et al. A comprehensive study of patients with surgically treated lumbar spinal stenosis with neurogenic diration. J Bone Joint Surg (Br), 2002, 84-A(11): 1954-1959.
7. Carreon LY, Glassman SD, Howard J. Fusion and nonsurgical treatment for symptomatic lumbar degenerative disease: a systematic review of Oswestry Disability Index and MOS Short Form-36 outcomes. Spine J, 2008, 8(5): 747-755.
8. Bowers C, Amini A, Dailey AT, et al. Dynamic interspinous process stabilization: review of complications associated with the X-Stop device. Neurosurg Focus, 2010, 28(6): E8.
9. Christie SD, Song JK, Fessler RG. Dynamic interspinous process technology. Spine (Phila Pa 1976), 2005, 30(16 Suppl): S73-78.
10. Phillips FM, Voronov LI, Gaitanis IN, et al. Biomechanics of posterior dynamic stabilizing device (DIAM) after facetectomy and discectomy. Spine J, 2006, 6(6): 714-722.
11. Tamburrelli FC, Proietti L, Logroscino CA. Critical analysis of lumbar interspinous devices failures: a retrospective study. Eur Spine J, 2011, 20 Supp1 1: S27-35.
12. Lee DY, Lee SH, Shim CS, et al. Decompression and interspinous dynamic stabilization using the locker for lumbar canal stenosis associated with low-grade degenerative spondylolisthesis. Minim Invasive Neurosurg, 2010, 53(3): 117-121.
13. Siepe CJ, Heider F, Beisse R, et al. Treatment of dynamic spinal canal stenosis with an interspinous spacer. Oper Orthop Traumatol, 2010, 22(5-6): 524-535.
14. 孙浩林, 李淳德, 刘宪义, 等. 棘突间固定系统与融合固定系统联合应用治疗腰椎退变性疾患. 中华外科杂志, 2010, 48(5): 363-367.
15. 王欢, 崔少千, 王海义, 等. 重建椎管后部结构治疗腰椎管狭窄症. 中国修复重建外科杂志, 2005, 19(12): 982-985.
16. Fransen P. Prevention of scar tissue formation in spinal surgery: state of the art and review of the literature. J Neurosurg Sci, 2011, 55(3): 277-281.
17. Fransen P. Reduction of postoperative pain after lumbar microdiscectomy with DuraSeal Xact Adhesion Barrier and Sealant System. Spine J, 2010, 10(9): 751-761.
18. 王洪伟, 阮美树, 孙连星, 等. “天窗式”责任节段整块椎板切除减压固定融合治疗复杂性腰椎管狭窄症. 中国矫形外科杂志, 2011, 19(7): 611-612.
19. Chen E, Tong KB, Laouri M. Surgical treatment patterns among Medicare beneficiaries newly diagnosed with lumbar spinal stenosis. Spine J, 2010, 10(7): 588-594.

Chinese Journal of Reparative and Reconstructive Surgery

SHORT-TERM EFFECTIVENESS OF INTERLAMINAR LUMBAR INSTRUMENTED FUSION THROUGH A SMALL INCISION FOR LUMBAR SPINAL STENOSIS

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