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Instrumented transforaminal lumbar interbody fusion with single cage for the treatment of degenerative lumbar disease

  • Orthopaedic Surgery
  • Published:
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Abstract

Introduction

There are several practical problems encountered in the TLIF procedure with implantation of two titanium cages, such as difficulty in achieving symmetric positioning with two cages, loosening of the first cage following insertion of the second cage and higher direct costs to the patient.

Method

From January 2005 to December 2007, a total of 76 consecutive patients treated with instrumented TLIF with single cage and excised local bone were enrolled in the current study. There were 45 males and 31 females aged between 31 and 75 years (mean 50.9 years). Forty-five patients had degenerative disc diseases alone, 23 had associated isthmic or degenerative spondylolisthesis and 8 had recurrent disc herniations. Clinical outcomes were evaluated using the Oswestry Disability Index and a visual analog scale. Intervertebral height and fusion status were assessed on X-ray and two-dimensional computed tomography reconstruction.

Results

All the patients followed up. The mean follow-up period was 21.8 months (range from 12 to 48 months). No nerve injuries occurred during operation. Postoperative ODI and VAS scores in all the patients were more than the preoperative ones with significant differences. All the patients had complete interbody fusion and, at the final follow-up, none had instrumentation failure. Postoperative intervertebral height in all the patients was better than the preoperative ones with statistical significances.

Conclusions

Instrumented TLIF with single cage is a safe and effective method for the treatment of degenerative lumbar diseases.

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Acknowledgments

This work was supported partly by the National Natural Science Foundation of China (30970718), partly by the Program of Shanghai Subject Chief Scientist (A type) (07XD14006), partly by the National High tech Research and Development Program (863 program) (2007AA03Z313), partly by the Shanghai International Science and Technology Partnership Program (09410702700), partly by the “Technology Innovation Action Plan” Key Project of Shanghai Science and Technology Commission (08411952500), partly by the “Technology Innovation Action Plan” Key Project of Shanghai Science and Technology Commission (09411953800) and partly by the Program for Outstanding Medical Academic Leader.

Conflict of interest

The authors have no financial ties to any of the companies that manufacture the materials used in the current study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Jian Zhou, Jian Dong, Xilei Li, Xiaogang Zhou, Taolin Fang & Hong Lin

  2. Department of Orthopaedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China

    Bo Wang

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  1. Jian Zhou
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  2. Bo Wang
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  3. Jian Dong
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  5. Xiaogang Zhou
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  7. Hong Lin
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Correspondence to Jian Dong.

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Zhou, J., Wang, B., Dong, J. et al. Instrumented transforaminal lumbar interbody fusion with single cage for the treatment of degenerative lumbar disease. Arch Orthop Trauma Surg 131, 1239–1245 (2011). https://doi.org/10.1007/s00402-011-1292-7

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  • DOI: https://doi.org/10.1007/s00402-011-1292-7

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