Posterolateral Fusion Group Research Articles

腰椎後方手術におけるｐｅｄｉｃｌｅ ｓｃｒｅｗの併用 後側方固定群との比較検討

To assess the indications for using pedicular screwing (PS) for lumbar arthrodesis, we compared 25 cases treated with PS with 47 cases posterolateral fusion (PLF) cases.The PS gained significantly better clindcal results than the PLF Group, due to relief of low back pain (LBP). The group also achieved good bone union and reduction of movement or olisthesis of the unstable segment. However developed some new olistheses lower adjacent segment.We concluded that the use of PS should be limited to: 1) middlu aged patients 2) unstable segments with LBP 3) For patients without multiple degenerative segments.

The Steffee Variable Screw Placement System Using Different Methods of Bone Grafting

Two groups of patients with diseased lumbar spines treated by the Steffee variable screw placement system were studied, in order to compare concomitant posterolateral fusion and posterior lumbar interbody fusion. The use of posterolateral fusion resulted in less invasiveness than posterior lumbar interbody fusion, with regard to operating time and blood loss. With the posterolateral fusion method, correction of olisthesis or kyphotic deformity, if attained at all, was difficult to maintain. Posterior lumbar interbody fusion produced better correction and maintenance, even in osteoporotic cases. Bone union was achieved at an average of 11 months in only 60% of the posterolateral fusion group, whereas it was complete within a significantly shorter period (average; 6 months) in 91% of the posterior lumbar interbody fusion group. Breakage or loosening of screws occurred in 14% of the posterolateral fusion group. Deep wound infection and adhesive arachnoiditis, which were never seen in the posterolateral fusion group, developed in 3% of the posterior lumbar interbody fusion group. Posterior lumbar interbody fusion is considered to be a better method of bone grafting than posterolateral fusion, when used with the Steffee variable screw placement system.