|Co-Author(s):||Papanikolaou P.G., Kotselas V.K., Petsanas D.(*), Atzemi-|
|Moldow N, Hatzidakis G.I., Georgopoulos Ch.E.|
Background: We present a series of patients with lumbar acquired degenerative disc disease treated surgically by microdiscectomy and posterior lumbar interbody fusion using a minimally invasive B-twin expandable spinal spacer.
Material and methods: During a 3-years period (2002-2004) 85 patients were treated surgically using the particular method. 46 were men and 39 women, age ranged from 25 to 75 years (45.7 years average). All had low back pain with or without radiculopathy caused by acquired lumbar disc degeneration confirmed by magnetic resonance imaging. Surgical procedure was bilateral microdiscectomy and subarticular fenestration for lateral recess decompression followed by insertion of a minimally invasive B-twin expandable spinal spacer together with intervertebral heterologous bone graft. . For 45 cases (52.9%) operation was at 1 level, for 35 cases (41.2%) at 2 levels, for 4 cases (4.7%) at 3 levels and for 1 case (1.2%) at 4 levels. Levels were L5-S1 in 53 cases, L4-L5 in 56 cases, L3-L4 in 20 cases and L2-L3 in 2 cases (totally 130 levels in 85 patients). Laminectomy was performed in 3 cases and pendicle screw fixation in 5 cases. Extraforaminal disc prolapse was found in 2 cases. Synovial cyst was seen in 1 case.
Results: Follow-up time ranged from 6 months to 2 years. There were no remarkable surgical complications (dural laceration, neurological deficit or infection). Numerical Rating Scale was used for pain intensity assessment. All except 2 patients were improved as for back and/or leg pain (result: excellent in 41 or 48.2%, very good in 40 or 47%, good in 2 or 2.4% and no improvement in 2 or 2.4%). Lumbar spine radiography was done at 6 months, 1 year and 2 years post-op. Fusion was demonstrated in all patients, with remarkable increase of disc space height.
Conclusion: Posterior lumbar interbody fusion with a minimally invasive B-twin expandable spinal spacer achieves excellent outcome with very low complication rate.