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Bilateral decompression using a unilateral pedicle construct for lumbar stenosis

International Orthopaedics volume 38, pages 573–578 (2014)Cite this article

Abstract

Purpose

To determine the effectiveness of bilateral decompression via a unilateral approach using unilateral pedicle screw fixation for two-level lumbar stenosis with instability.

Methods

Between October 2006 and October 2010, 98 patients (61 men and 37 women) who had reached the three-year follow-up interval were treated with unilateral pedicle screw fixation at the authors’ institution. All patients underwent two-level transforaminal lumbar interbody fusion (TLIF), and the mean age was 59.6 years (range, 40–72). Visual analog scale (VAS) scores and Oswestry Disability Index (ODI) were used to assess the pre-operative and postoperative clinical results. Fusion status, the disc space height, and the whole lumbar lordotic angle were analysed for the radiological evaluation.

Results

The ODI scores decreased significantly in both early and late follow-up evaluations and the visual analog scale (VAS) score demonstrated significant improvement in late follow-up (P < 0.01). The disc space height (P < 0.05) and the whole lumbar lordotic angle (P < 0.05) were increased at the final follow-up. Successful fusion was achieved in all patients.

Conclusion

Bilateral decompression via a unilateral approach using unilateral pedicle screw fixation for two-level lumbar stenosis with instability, which can maintain the lumbar lordosis and the disc space height, is an effective and less invasive method than with bilateral constructs.

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Acknowledgments

This study was supported by the National Natural Science Foundation of China (grant no. 81071453 and 81071503), Program for Innovative Research Team of Shanghai Municipal Education Commission, and Fund for Key Discipline of Shanghai Municipal Education Commission (J50206).

We are very grateful to Dr. Zong-Ping Luo for his valuable suggestions on this work.

Financial disclosures for all authors

The authors declare that they have no conflict of financial interest.

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Affiliations

  1. Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Rd, Shanghai, 200011, China

    Lu Mao, Jie Zhao, Ke-rong Dai, Li Hua & Xiao-jiang Sun

Authors
  1. Lu Mao
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  2. Jie Zhao
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  3. Ke-rong Dai
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  4. Li Hua
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  5. Xiao-jiang Sun
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Corresponding author

Correspondence to Jie Zhao.

Additional information

Drs Mao and Li contributed equally to this study.

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Mao, L., Zhao, J., Dai, Kr. et al. Bilateral decompression using a unilateral pedicle construct for lumbar stenosis. International Orthopaedics (SICOT) 38, 573–578 (2014). https://doi.org/10.1007/s00264-013-2225-6

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  • DOI: https://doi.org/10.1007/s00264-013-2225-6

Keywords

  • Unilateral
  • Transforaminal lumbar interbody fusion
  • Lumbar stenosis
  • Invasive