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 

 PDF  Full Text DOI: 10.25107/2474-1647.3409

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

Cite the article

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..