Minimally invasive unilateral lumbar interbody fusion (UNILIF) in over-80-year-olds. Continuous series of 42 patients at 1.4 years' follow-up.

Autor: Ould-Slimane M; Service de chirurgie orthopédique et traumatologique, institut régional du Rachis, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France., Cantogrel P; Service de chirurgie orthopédique et traumatologique, institut régional du Rachis, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France., Lefèvre E; Service de chirurgie orthopédique et traumatologique, institut régional du Rachis, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France., Parent HF; Clinique Saint-Léonard, 18, rue de Bellinière, 49800 Trélazé, France., Gauthé R; Service de chirurgie orthopédique et traumatologique, institut régional du Rachis, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France. Electronic address: gautheremi@gmail.com.
Jazyk: angličtina
Zdroj: Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2020 Apr; Vol. 106 (2), pp. 275-279. Date of Electronic Publication: 2020 Mar 11.
DOI: 10.1016/j.otsr.2020.01.003
Abstrakt: Introduction: In lumbar stenosis, surgery aims to improve quality of life in increasingly elderly patients. Minimally invasive techniques better suit the requirements of elderly patients with increasing functional demand.
Hypothesis: The UNILIF unilateral lumbar interbody fusion technique improves functional scores at 1 year in over-80 year-olds, with low morbidity.
Method: Patients undergoing minimally invasive decompression with transforaminal lumbar interbody fusion (TLIF) associated to unilateral pedicle screwing for degenerative lumbar stenosis were analyzed at a minimum 1 year's follow-up. SF12, Oswestry Disability Index (ODI) and Quebec scores and sagittal spinopelvic radiographic parameters were assessed at follow-up. Surgical and general complications were also collated.
Results: In all, 42 patients (64.3% female; mean age, 83.7±2.9 years) were treated by UNILIF at levels L2-L3 (3.8%), L3-L4 (15.4%), L4-L5 (71.2%) and L5-S1 (9.6%). Mean follow-up was 520±226 days (range, 340-1166 days). Mean preoperative SF12 score was 77.5±10.9, with significant improvement at last follow-up: 81.9±138 (p<0.05). Mean preoperative ODI was 44.4%±14.0, with significant improvement at last follow-up: 32.4%±13.3 (p<0.001). Mean preoperative Quebec score was 42.9±19.9, with significant improvement at last follow-up: 28.5±21.9 (p<0.001). Spinopelvic sagittal balance was not affected by the UNILIF procedure. There were no cases of infection or severe general complications during follow-up, although 2 cases of non-union required revision surgery.
Conclusion: Lumbar stenosis surgery by UNILIF improved functional scores at 1 year, with low morbidity. It is a suitable strategy for degenerative lumbar stenosis in elderly patients.
Level of Evidence: IV, non-comparative cohort study.
(Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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