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báo cáo khoa học: "Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: A case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: A case series | Tender et al. Journal of Medical Case Reports 2011 5 454 http www.jmedicalcasereports.eom content 5 1 454 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis A case series Gabriel C Tender1 Larry E Miller2 3 and Jon E Block 3 Abstract Introduction Traditional surgical management of lumbosacral spondylolisthesis is technically challenging and is associated with significant complications. The advent of minimally invasive surgical techniques offers patients treatment alternatives with lower operative morbidity risk. The combination of percutaneous pedicle screw reduction and an axial presacral approach for lumbosacral discectomy and fusion offers an alternative procedure for the surgical management of low-grade lumbosacral spondylolisthesis. Case presentation Three patients who had L5-S1 grade 2 spondylolisthesis and who presented with axial pain and lumbar radiculopathy were treated with a minimally invasive surgical technique. The patients-a 51-year-old woman and two men ages 46 and 50 -were Caucasian. Under fluoroscopic guidance spondylolisthesis was reduced with a percutaneous pedicle screw system resulting in interspace distraction. Then an axial presacral approach with the AxiaLIF System TranS1 Inc. Wilmington NC USA was used to perform the discectomy and anterior fixation. Once the axial rod was engaged in the L5 vertebral body further distraction of the spinal interspace was made possible by partially loosening the pedicle screw caps advancing the AxiaLIF rod to its final position in the vertebrae and retightening the screw caps. The operative time ranged from 173 to 323 minutes and blood loss was minimal 50 mL . Indirect foraminal decompression and adequate fixation were achieved in all cases. All patients were ambulatory after surgery and reported relief from pain and resolution of radicular symptoms. No perioperative .