Spondylodesist követoen kialakult szomszédos szegmentum betegség megoldása minimálisan invazív, anterolateralis feltárásból a lumbális gerincszakaszon: Nem szükséges dorsalis mutét?

Translated title of the contribution: Treatment of post spondylodesis adjacen segment disease with minimally invasive, anterolateral surgery on lumbar spine: There is no need for dorsal operation?

Attila Schwarcz, Péter Szakály, A. Büki, T. Dóczi

Research output: Contribution to journalArticle

Abstract

Adjacent segment disease (ASD) occurs with a probability of 30% in the lumbar spine following spinal fusion surgery. Usually advanced degenerative changes happen cranially to the fused lumbar segment. Thus, secondary spinal instability, stenosis, spodylolisthesis, foraminal stenosis can lead to the recurrence of the pain not always amenable to conservative measures. A typical surgical solution to treat ASD consists of posterior revision surgery including decompression, change or extension of the instrumentation and fusion to the rostral level. It results in a larger operation with considerable risk of complications. We present a typical case of ASD treated surgically with a new minimally invasive way not yet performed in Hungary. We use anterolateral abdominal muscle splitting approach to reach the lumbar spine through the retroperitoneum. A discectomy is performed by retracting the psoas muscle dorsally. The intervertebral bony fusion is achieved by implanting a cage with large volume that is stuffed with autologous bone or tricalcium phosphate. A cage with large volume results in excellent annulus fibrosus tension, immediate stability and provides large surface for bony fusion. A stand-alone cage construct can be supplemented with lateral screw/rod/plate fixation. The advantage of the new technique for the treatment of ASD includes minimal blood loss, short operation time, significantly less postoperative pain and much less complication rate.

Original languageHungarian
Pages (from-to)273-277
Number of pages5
JournalIdeggyógyászati szemle
Volume68
Issue number7-8
DOIs
Publication statusPublished - Jul 30 2015

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Spinal Fusion
Minimally Invasive Surgical Procedures
Spine
Psoas Muscles
Abdominal Muscles
Spinal Stenosis
Diskectomy
Hungary
Therapeutics
Postoperative Pain
Decompression
Reoperation
Pathologic Constriction
Bone and Bones
Recurrence
Pain

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Medicine(all)

Cite this

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title = "Spondylodesist k{\"o}vetoen kialakult szomsz{\'e}dos szegmentum betegs{\'e}g megold{\'a}sa minim{\'a}lisan invaz{\'i}v, anterolateralis felt{\'a}r{\'a}sb{\'o}l a lumb{\'a}lis gerincszakaszon: Nem sz{\"u}ks{\'e}ges dorsalis mut{\'e}t?",
abstract = "Adjacent segment disease (ASD) occurs with a probability of 30{\%} in the lumbar spine following spinal fusion surgery. Usually advanced degenerative changes happen cranially to the fused lumbar segment. Thus, secondary spinal instability, stenosis, spodylolisthesis, foraminal stenosis can lead to the recurrence of the pain not always amenable to conservative measures. A typical surgical solution to treat ASD consists of posterior revision surgery including decompression, change or extension of the instrumentation and fusion to the rostral level. It results in a larger operation with considerable risk of complications. We present a typical case of ASD treated surgically with a new minimally invasive way not yet performed in Hungary. We use anterolateral abdominal muscle splitting approach to reach the lumbar spine through the retroperitoneum. A discectomy is performed by retracting the psoas muscle dorsally. The intervertebral bony fusion is achieved by implanting a cage with large volume that is stuffed with autologous bone or tricalcium phosphate. A cage with large volume results in excellent annulus fibrosus tension, immediate stability and provides large surface for bony fusion. A stand-alone cage construct can be supplemented with lateral screw/rod/plate fixation. The advantage of the new technique for the treatment of ASD includes minimal blood loss, short operation time, significantly less postoperative pain and much less complication rate.",
keywords = "Adjacent segment disease, Cage, Spondylodesis",
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year = "2015",
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T1 - Spondylodesist követoen kialakult szomszédos szegmentum betegség megoldása minimálisan invazív, anterolateralis feltárásból a lumbális gerincszakaszon

T2 - Nem szükséges dorsalis mutét?

AU - Schwarcz, Attila

AU - Szakály, Péter

AU - Büki, A.

AU - Dóczi, T.

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