Unilateral augmented pedicle screw fixation for foraminal stenosis.
OBJECTIVE
The purpose of this study is to evaluate the effectiveness of unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis.


METHODS
The study group comprises consecutive 16 patients who underwent unilateral decompression and bone cement augmented pedicle screw fixation from May 2003 to January 2006. The patients were evaluated by visual analog scale (VAS) for pain and the scoring system of the Japanese Orthopedic Association (JOA) for low back pain. The result of surgery was also evaluated with McNab's classification. Excellent or good outcome was considered as successful. The patients were followed at postoperative 1 month, 3 month, 6 month, and 1 year with standing AP and lateral films.


RESULTS
The average VAS and JOA score of the 16 patients were 7.8 (range, 6-9) and 5.8 (range, 3 - 10) before surgery and 2.2 (range, 0 - 5) and 12.3 (range, 9 - 15) at the time of last follow up. Both VAS and JOA score improved significantly after the surgery (p < 0.05, t-test). All patients improved after the operation and no revision surgery was required. No metal failure or pseudoarthrosis was observed during the follow-up. The success rate was 87.5%.


CONCLUSIONS
Our data suggest that unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis is an effect method for obtaining satisfactory clinical outcome. Its possible advantage is shorter operation time and reduced surgical extent. We believe that the reduced stiffness of unilateral fixation was compensated by pedicle screw augmentation and interbody fusion.
Kim
Jeong-Gyun
JG
Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Jin
Yong-Jun
YJ
Chung
Sang Ki
SK
Kim
Ki-Jeong
KJ
Kim
Hyun-Jib
HJ
J Spinal Disord. 1992 Mar;5(1):39-49
1571614
Spine J. 2004 Jul-Aug;4(4):402-8
15246300
Spine (Phila Pa 1976). 2000 Jul 15;25(14):1843-7
10888955
Clin Orthop Relat Res. 1986 Feb;(203):99-112
3956001
Spine (Phila Pa 1976). 1991 Mar;16(3 Suppl):S155-61
2028332
J Neurosurg Spine. 2008 Jan;8(1):44-51
18173346
Clin Orthop Relat Res. 1993 Nov;(296):278-87
8222439
Spine (Phila Pa 1976). 2002 Jul 15;27(14):1536-42
12131714
Spine (Phila Pa 1976). 2007 Feb 15;32(4):395-401
17304127
J Spinal Disord Tech. 2008 Jul;21(5):324-7
18600141
J Bone Joint Surg Am. 1971 Jul;53(5):891-903
4326746
Clin Orthop Relat Res. 1981 Jun;(157):191-9
7249453
Spine (Phila Pa 1976). 1991 Nov;16(11):1312-20
1750006
Acta Orthop Belg. 2004 Dec;70(6):578-82
15669459
J Neurosurg. 1999 Jan;90(1 Suppl):52-8
10413126
Spine (Phila Pa 1976). 2006 May 15;31(11 Suppl):S89-95; discussion S104
16685242
Spine J. 2003 Sep-Oct;3(5):400-3
14588953
Int Orthop. 2009 Aug;33(4):1043-7
18521599
Spine (Phila Pa 1976). 2002 Feb 1;27(3):223-9
11805682
J Spinal Disord Tech. 2006 Jun;19(4):249-56
16778658
Spine (Phila Pa 1976). 2000 Feb 1;25(3):389-94
10703115
Neurosurgery. 2003 Dec;53(6):1354-60; discussion 1360-1
14633301