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

Attila Schwarcz, Péter Szakály, András Büki, Tomás Dóczi

Research output: Article

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
JournalIdeggyogyaszati szemle
Volume68
Issue number7-8
DOIs
Publication statusPublished - júl. 30 2015

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Keywords

  • Adjacent segment disease
  • Cage
  • Spondylodesis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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