Abstract
BackgroundFailure of pedicle screw fixation is often seen in patients with severe osteoporosis. We developed new lumbar spinal instrumentation (Tadpole system) for elderly patients who have osteoporotic bone and poor general health status. The objective of this study was to document the long-term clinical outcomes after Tadpole system fixation, the rate of spinal fusion, the incidence of adjacent segment degeneration, the rate of instrumentation failure, and the overall complications.MethodsSixty patients who underwent posterolateral spinal fusion using the Tadpole system, in whom a radiograph of the lumbar spine was taken at more than 5 years after operation, were involved in this study. The improvement rate of the Japanese Orthopaedic Association (JOA) score, rate of spinal fusion, presence or absence of adjacent segment degeneration, rate of instrumentation failure, and postoperative complications of each patient were assessed at 5 years postoperatively.ResultsThe mean JOA score improvement was 72.5%, and the posterolateral spinal fusion rate was 93.3% (56 of 60 patients) at the last follow-up. Adjacent segment degeneration occurred in only two patients who showed decreased intervertebral disc height, and instrumentation failure (hook deviation) was observed in one patient. No other complications were observed in any patients.ConclusionTadpole system fixation shows favorable long-term clinical outcomes.
Highlights
In the last 20 years, the pedicle screw system as part of fixation for lumbar fusion has had good clinical results [1,2,3]
In a rapidly aging society, a large number of lumbar spinal surgeries are being performed in elderly patients with degenerative diseases, but failure of pedicle screw fixation is often seen in patients with severe osteoporosis [4,5]
We developed new lumbar spinal instrumentation, the ‘Tadpole system’ (KiSCO Co., Ltd., Kobe, Japan, Figure 1), for elderly patients who have osteoporotic bone and poor general health status, who may have a high risk for complex surgeries, and who do not desire a higher activity level in daily life [6]
Summary
In the last 20 years, the pedicle screw system as part of fixation for lumbar fusion has had good clinical results [1,2,3]. We developed new lumbar spinal instrumentation (Tadpole system) for elderly patients who have osteoporotic bone and poor general health status. The objective of this study was to document the long-term clinical outcomes after Tadpole system fixation, the rate of spinal fusion, the incidence of adjacent segment degeneration, the rate of instrumentation failure, and the overall complications
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