Feasibility of manufacturing a patient-specific spinal implant
Feasibility of manufacturing a patient-specific spinal implant
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制造患者专用脊柱植入物的可行性
DOI：
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发表时间：
2016
期刊：
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通讯作者：
L. Wilson
中科院分区：
文献类型：
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作者：
F. Sedra;A. Afsharpad;B. Dala;Robert S. Lee;L. Wilson
背景背景：近年来，侧向腰椎融合术越来越受欢迎。它利用腹膜后经腰肌入路以微创方式到达椎间盘间隙。它可以更好地进行椎间盘间隙和大尺寸笼的插入。目的：比较侧向腰椎椎间融合术 (LLIF) 和微创经椎间孔椎间融合术 (MI-TLIF) 的影像学和临床结果。研究设计/设置：回顾性审查。患者样本：我们纳入了 60 名在 82 个级别进行手术的患者：第 1 组 LLIF (n = 28)，第 2 组 MI-TLIF (n = 32)。我们测量了 L3/L4 或 L4/L5 的放射学结果。结果测量：放射学：椎间盘高度、椎间孔高度、节段前凸、整体腰椎前凸。临床结果包括视觉模拟评分 (VAS)、Oswestry 残疾指数 (ODI) 和欧洲生活质量 5 维度 (EQ-5D)。方法：通过术前、术后即刻和最后一次随访时的站立侧位 X 线测量放射学结果。记录术前、术后 6-8 周以及最后一次随访时的临床结果。结果：第 1 组：椎间盘高度平均改善 9.1 mm，椎间孔高度 5 mm，节段前凸 6.75，腰椎前凸 15.4，ODI 37，VAS 56.2，EQ-5D 54。第 2 组：椎间盘高度 5.8 mm，椎间孔高度 3.5 mm，节段前凸 4.5，整体前凸 10.3， ODI 18、VAS 26、EQ-5D 23.5。除 ODI 外，参数差异具有统计学显着性 (p<.05)。结论：与 MI-TLIF 相比，通过外侧入路插入的融合器能够改善腰椎/节段前凸，并且在恢复椎间盘和椎间孔高度方面优于 MI-TLIF。与 MI-TLIF 组相比，LLIF 组患者的临床结果有所改善。利益冲突：无利益冲突。资金来源：未获得资金。
BACKGROUND CONTEXT: Lateral approach to lumbar fusion has been gaining popularity in recent years. It utilises a retroperitoneal transpsoas approach to reach the disc space in a minimally invasive fashion. It allows better access for disc clearance and insertion of large foot print cages. PURPOSE: To compare radiographic and clinical results following lateral lumbar interbody fusion (LLIF) and minimally invasive transforaminal interbody fusion (MI-TLIF). STUDY DESIGN/SETTING: Retrospective review. PATIENT SAMPLE: We included 60 patients operated at 82 levels: Group 1 LLIF (n = 28), Group 2 MI-TLIF (n = 32). We measured radiological outcomes at L3/L4 or L4/L5. OUTCOME MEASURES: Radiological: Disc height, foraminal height, segmental lordosis, overall lumbar lordosis. Clinical outcomes included visual analogue scores (VAS), Oswestry Disability Index (ODI) and European Quality of Life-5 Dimensions (EQ-5D). METHODS: Radiological outcomes were measured on standing lateral X-rays preoperatively, immediately postoperatively and at the last follow up. Clinical outcomes were recorded preoperatively, at 6–8 weeks postoperatively and at the last follow-up. RESULTS: Group 1: Mean improvement in disc height 9.1 mm, foraminal height 5 mm, segmental lordosis 6.75, lumbar lordosis 15.4, ODI 37, VAS 56.2, EQ-5D 54. Group 2: Disc height 5.8 mm, foraminal height 3.5 mm, segmental lordosis 4.5, overall lordosis 10.3, ODI 18, VAS 26, EQ-5D 23.5. Difference in parameters was statistically significant (p<.05) apart from ODI. CONCLUSIONS: Cages inserted via the lateral approach have the ability to improve lumbar/segmental lordosis and is superior in restoring disc and foraminal height compared to MI-TLIF. Patients in the LLIF group showed improved clinical outcomes compared to the MI-TLIF group. CONFLICTS OF INTEREST: No conflict of interest. FUNDING SOURCES: No funding obtained.