Minimally invasive anterior lumbar interbody fusion followed by percutaneous translaminar facet screw fixation in elderly patients.
OBJECTIVE
The purpose of this study was to determine whether anterior lumbar interbody fusion (ALIF) followed by percutaneous translaminar facet screw fixation is effective in elderly patients with degenerative spinal disease.


METHODS
Twenty-nine patients > 60 years old who underwent ALIF with percutaneous translaminar facet screw fixation from January to June 2004 were studied. The radiological and clinical data of these patients were collected and analyzed. The mean follow-up period was 14.6 months (range 12-17 months).


RESULTS
The mean preoperative, immediate postoperative, and 6- and 12-month postoperative posterior disc heights were 7.1, 11.6, 9.8, and 9.8 mm, respectively. Subsidences of posterior disc height > 20% developed in 9 patients (30%). The significant risk factor for subsidence was found to be 2-level operations (p = 0.023). The mean preoperative Oswestry Disability Index score and visual analog scale scores for the back and leg were 24.4, 6.6, and 7.5, respectively, and improved postoperatively to 14.2, 1.5, and 1.8, respectively.


CONCLUSIONS
Minimally invasive ALIF followed by percutaneous translaminar facet screw fixation was performed as a minimally invasive surgical technique in elderly patients. However, in certain circumstances such as multilevel operations or in patients with severe osteoporosis, significant cage subsidence can develop.
Park
Sung Hun
SH
Department of Neurosurgery, Daejeon Woori Spine Hospital, Seo-gu, Daejeon, South Korea.
Park
Woo Min
WM
Park
Cheul Woong
CW
Kang
Kwan Soo
KS
Lee
Young Keun
YK
Lim
Sang Rak
SR
D000368:Aged; D001863:Bone Screws; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*