Effectiveness and safety of transforaminal lumbar interbody fusion in patients with previous laminectomy

摘要

PurposeTo determine the efficacy and safety of transforaminal lumbar interbody fusion (TLIF) for revision lumbar spine surgery in patients with previous laminectomy. The secondary objective was to evaluate the clinical and radiological outcome after such a procedure.MethodsRetrospective case series study. Eighty-two patients were included. There were 48 women (58.5?%) and 34 men (41.5?%) with a mean age of 51?years (range 26–84) at the time of index procedure. The outpatient and inpatient charts were reviewed to identify patients’ demographic data, preoperative, perioperative, and postoperative data. The outcome measures were assessed by Oswestry Disability Index (ODI) and visual analog scale (VAS) for back and leg pain. An independent spine surgeon and musculoskeletal radiologist reviewed the imaging studies.ResultsThe average operative time was 160?min (range 131–250). The average estimated blood loss was 652?cc (100–1,400?cc). Nineteen patients (23.1?%) required blood transfusion. Five patients (6?%) had dural tear. One patient (1.2?%) had a surgical site infection. Two patients (2.4?%) had thromboembolic events. The average hospital stay was 3.8?days (2–5?days). At a mean follow-up of 28?months, there were statically significant improvement in the ODI and VAS for back and leg pain. None of the patients’ radiographs showed hardware failure or pedicle screw loosening and no patient returned to the operating room for pseudarthrosis.ConclusionsThe current study confirmed that TLIF approach in patients with previous laminectomy is effective and safe with good outcomes...