Abstract:
BACKGROUND:Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported. QUESTIONS/PURPOSES:We determined (1) changes to the Oswestry Disability Index, (2) frequency of radiographic fusion, (3) complications and reoperations, and (4) the learning curve associated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. METHODS:We reviewed our first 124 patients who underwent minimally invasive transforaminal lumbar interbody fusion to treat low-grade spondylolisthesis and degenerative lumbar diseases and did not need a major deformity correction. This represented 63% (124 of 198) of the transforaminal lumbar interbody fusion procedures we performed for those indications during the study period (2003-2007). Eighty-three (67%) patients had complete 5-year followup. Plain radiographs and CT scans were evaluated by two reviewers. Trends of surgical time, blood loss, and hospital stay over time were examined by logarithmic curve fit-regression analysis to evaluate the learning curve. RESULTS:At 5 years, mean Oswestry Disability Index improved from 60 points preoperatively to 24 points and 79 of 83 patients (95%) had improvement of greater than 10 points. At 5 years, 67 of 83 (81%) achieved radiographic fusion, including 64 of 72 patients (89%) who had single-level surgery. Perioperative complications occurred in 11 of 124 patients (9%), and another surgical procedure was performed in eight of 124 patients (6.5%) involving the index level and seven of 124 patients (5.6%) at adjacent levels. There were slowly decreasing trends of surgical time and hospital stay only in single-level surgery and almost no change in intraoperative blood loss over time, suggesting a challenging learning curve. CONCLUSIONS:Oswestry Disability Index scores improved for patients with spondylolisthesis and degenerative lumbar diseases treated with minimally invasive transforaminal lumbar interbody fusion at minimum 5-year followup. We suggest this procedure is reasonable for properly selected patients with these indications; however, traditional approaches should still be performed for patients with high-grade spondylolisthesis, patients with a severely collapsed disc space and no motion seen on the dynamic radiographs, patients who need multilevel decompression and arthrodesis, and patients with kyphoscoliosis needing correction. LEVEL OF EVIDENCE:Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Park Y,Ha JW,Lee YT,Sung NYdoi
10.1007/s11999-013-3241-ysubject
Has Abstractpub_date
2014-06-01 00:00:00pages
1813-23issue
6eissn
0009-921Xissn
1528-1132journal_volume
472pub_type
杂志文章abstract::A trigonometric evaluation of the amount of correction of metatarsus primus varus obtainable via lateral displacement of the first metatarsal head in a Chevron osteotomy technique revealed that approximately 1 degree of correction may be obtained for each millimeter of lateral shift. This calculated correction was cor...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract:UNLABELLED:Replacement of bone segments after resection of a tumor-containing bone has a long history, and currently metallic implants and allografts have reasonable rates of success in terms of patient survival and restoration of useful function. Total femoral resections for extensive tumors are uncommon but clearly r...
journal_title:Clinical orthopaedics and related research
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doi:10.1097/00003086-200509000-00012
更新日期:2005-09-01 00:00:00
abstract::A test for knee posterolateral instability, which is a modification of the standard posterolateral rotatory instability test, is described. In this test, the patient lies supine on the examination table with hips and knees flexed to 90 degrees. The examiner grasps both feet and attempts to maximally externally rotate ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::Eleven patients with Legg-Calvé-Perthes disease (LCP) were examined ultrasonographically for their femoral head deformity. The outline of the cartilaginous femoral head was well demonstrated, and the image obtained corresponded to that observed by arthrography. Using ultrasonography, a simple method was developed to d...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract::Osteogenic proteins, also referred to as BMPs, are a family of bone matrix polypeptides isolated from a variety of mammalian species. These proteins are members of the transforming growth factor-beta superfamily of molecules that contain a highly conserved 7 cysteine transforming growth factor-beta domain in their C-t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::Varus deformity is a common finding in candidates for total knee arthroplasty (TKA), but very little has been written concerning the problems encountered in correcting these deformities at the time of arthroplasty. Compared to patients without deformities, this group of patients require more attention to the technical...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::Sixteen human trabecular bone biopsies were obtained from sites located in the ilium and in the area of the greater trochanter of the femur. Patients ranged from 19 to 85 years old and included men and women. All bone surfaces observed contained osteoid. Flat, branched fibroblastic-like cells were observed lining bone...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::The Hoffmann external fixator has proved to be an effective means of stabilizing complex femoral fractures in patients in whom prolonged traction or internal fixation is not advisable. It provides for the prompt mobilization of multiple-trauma victims and assists in the evaluation of the "floating knee." Pin tract inf...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::Some patients who had cervical laminoplasty with subsequent substantial loss of cervical lordosis have shown failed healing of a repaired semispinalis cervicis. We also have identified some patients in whom it is difficult to repair the C2 spinous process during laminoplasty. We therefore quantitatively analyzed the m...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000160710.11991.33
更新日期:2005-07-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-05-01 00:00:00
abstract::Thirty-eight total knee arthroplasties in 36 patients were studied at 4 +/- 2 (mean, +/- SD) years follow-up evaluation. The Hospital for Special Surgery knee score improved from 59 +/- 9 (mean, +/- SD) before surgery to 83 +/- 11 (mean, +/- SD) (p less than 0.0001) at last evaluation. Good or excellent results were a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Soft tissue sarcomas are often inappropriately excised without adequate preoperative planning. Inappropriate (unplanned) excisions may adversely affect local recurrence, distant metastasis, patient survival, and /or postoperative function once properly evaluated. QUESTIONS/PURPOSES:We asked whether the clin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1392-7
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Coronal malalignment occurs frequently in TKA and may affect implant durability and knee function. Designed to improve alignment accuracy and precision, the patient-specific positioning guide is predicated on restoration of the overall mechanical axis and is a multifaceted new tool in achieving traditional g...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1996-6
更新日期:2012-01-01 00:00:00
abstract::In 15 documented cases, subluxation or dislocation of the hip was discovered months or years after previous multiple normal physical examinations. The examiners were unique in that six were professors specializing in childrens' orthopedics, four were board-certified orthopedists, and five were pediatricians. An increa...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract::Isolated capitellar fractures are rare, intraarticular fractures requiring an aggressive management regimen. Several treatment options have been described for the Type 1 fracture. A new technique of direct anatomic reduction and fixation of the fracture using a maxillofacial plate is reported. Advantages of this new t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract:UNLABELLED:We sought to determine whether open reduction and internal fixation in combination with free vascularized bone grafting and elbow contracture release is an effective treatment for patients with recalcitrant distal humeral nonunions with segmental bone loss. In addition, we wondered whether this treatment str...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2005-06-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract::A prospective, randomized study was performed in 54 female total arthroplasty patients to determine whether straight catheterization in the recovery room might reduce the incidence of postoperative urinary infection, urinary retention, and urinary catheterization. Thirty-one patients were straight catheterized in the ...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1988-06-01 00:00:00
abstract::Comminuted fractures of the femoral shaft, especially when combined with fractures of the hip, may be difficult to treat. A four-sided titanium alloy locking nail with transfixing screws was designed in 1967 and allows compression of the fracture site. If necessary, the nail may be inserted without intraoperative roen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 传,古典文章,历史文章,杂志文章
doi:10.1007/s11999-012-2496-z
更新日期:2012-10-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4676-0
更新日期:2016-06-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000063597.67412.e9
更新日期:2003-05-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1979-11-01 00:00:00
abstract::Despite the lack of consensus guidelines and randomized control trials, the use of arthroscopy for the treatment of osteoarthritis of the knee has increased over the last decade. Techniques used for the arthroscopic treatment of osteoarthritis of the knee include joint lavage, joint débridement, meniscectomy, abrasion...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
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更新日期:2007-02-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000176555.05105.df
更新日期:2005-10-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2206-2
更新日期:2012-05-01 00:00:00
abstract::Dislocation after hip replacement occurs at an overall incidence of 2% to 3% and has significant cost and morbidity implications. Statistically increased incidence is observed in females and in the elderly, and after reoperation procedures. Specific causes include cup malrotation, trochanteric migration, and decreased...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Stiffness after a TKA can cause patient dissatisfaction and diminished function, therefore it is important to characterize predictors of ROM after TKA. Studies of AP translation in conscious individuals disagree whether AP translation affects maximum knee flexion angle after implantation of a highly congruen...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3274-2
更新日期:2014-02-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Between 1976 and 1992, reinfection developed in 34 patients treated for an infected total hip arthroplasty with removal of the prosthesis and implantation of another prosthesis. These patients included 15 men and 19 women with a mean age of 62 years. Infection recurred an average of 2.2 years after reimplantation of t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199705000-00026
更新日期:1997-05-01 00:00:00