Clinical research of single cage plus unilateral pedicle screw placement for the treatment of lumbar degenerative instability

English Keywords:Lumbar degenerative instability  Interbody fusion  Unilateral  Pedicle screw

English Abstract:

  【Abstract】 Objective：To explore the clinical efficacy of single cage plus unilateral pedicle screw placement for the treatment of lumbar degenerative instability.Method：51 cases with lumbar degenerative instability patients underwent single cage plus unilateral pedicle screw instrumentation and fusion，of them，there were 32 males and 19 females，with age ranging from 41 to 72 years old.Most cases complained of low back pain combined with radiological pain in lower limbs.47 cases had single segment involved（1 case in L3/4，25 cases in L4/5，21 cases in L5/S1），4 cases had two segments involved（1 case in L3/4 and L4/5，3 cases in L4/5 and L5/S1）.All cases experienced unilateral laminectomy and transforamenal lumbar interbody fusion，the clinical outcome was assessed by JOA score system.Result：The blood loss was 90-430ml（140ml for single segment，240ml for double segements）.The surgical time was 100min for single segment involement and 150min for double segments.Incision infection has not found.The average JOA scores at preoperation and 1 year follow-up was 11 and 25 respectively.38 cases were rated as excellent（74.51%），10 cases as good（19.61%），2 cases as fair（3.92%） and 1 case as poor（1.96%） with the total excellent and good rate of 94.12%.Postoperative X-ray showed no evidence of instrument failure.Conclusion：Single cage plus unilateral pedicle screw placement for lumbar degenerative instability is reliable and less interference with lumbar stability.