Universität zu Köln

Rieger, Bernhard, Jiang, Hongzhen, Ruess, Daniel, Reinshagen, Clemens, Molcanyi, Marek, Zivcak, Jozef, Tong, Huaiyu and Schackert, Gabriele (2017). First clinical results of minimally invasive vector lumbar interbody fusion (MIS-VLIF) in spondylodiscitis and concomitant osteoporosis: a technical note. Eur. Spine J., 26 (12). S. 3147 - 3156. NEW YORK: SPRINGER. ISSN 1432-0932

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Abstract

First description of MIS-VLIF, a minimally invasive lumbar stabilization, to evaluate its safety and feasibility in patients suffering from weak bony conditions (lumbar spondylodiscitis and/or osteoporosis). After informed consent, 12 patients suffering from lumbar spondylodiscitis underwent single level MIS-VLIF. Eight of them had a manifest osteoporosis, either. Pre- and postoperative clinical status was documented using numeric rating scale (NRS) for leg and back pain. In all cases, the optimal height for the cage was preoperatively determined using software-based range of motion and sagittal balance analysis. CT scans were obtained to evaluate correct placement of the construct and to verify fusion after 6 months. Since 2013, 12 patients with lumbar pyogenic spondylodiscitis underwent MIS-VLIF. Mean surgery time was 169 +/- 28 min and average blood loss was less than 400 ml. Postoperative CT scans showed correct placement of the implants. Eleven patients showed considerable postoperative improvement in clinical scores. In one patient, we observed screw loosening. After documented bony fusion in the CT scan, the fixation system was removed in two cases to achieve lower material load. The load-bearing trajectories (vectors) of MIS-VLIF are different from those of conventional coaxial pedicle screw implantation. The dorsally converging construct combines the heads of the dorsoventral pedicle screws with laminar pedicle screws following cortical bone structures within a small approach. In case of lumbar spondylodiscitis and/or osteoporosis, MIS-VLIF relies on cortical bony structures for all screw vectors and the construct does not depend on conventional coaxial pedicle screws in the presence of inflamed, weak, cancellous or osteoporotic bone. MIS-VLIF allows full 360 degrees lumbar fusion including cage implantation via a small, unilateral dorsal midline approach.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rieger, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Jiang, Hongzhen UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruess, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Reinshagen, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED Molcanyi, Marek UNSPECIFIED UNSPECIFIED UNSPECIFIED Zivcak, Jozef UNSPECIFIED UNSPECIFIED UNSPECIFIED Tong, Huaiyu UNSPECIFIED UNSPECIFIED UNSPECIFIED Schackert, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-209580
DOI:	10.1007/s00586-016-4928-z
Journal or Publication Title:	Eur. Spine J.
Volume:	26
Number:	12
Page Range:	S. 3147 - 3156
Date:	2017
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-0932
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Clinical Neurology; Orthopedics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20958