title: Long-term result of posterolateral fusion of the lumbar spine using the Tadpole system.
abstract: BACKGROUND
  Failure of pedicle screw fixation is often seen in patients with severe osteoporosis. We developed new lumbar spinal instrumentation (Tadpole system) for elderly patients who have osteoporotic bone and poor general health status. The objective of this study was to document the long-term clinical outcomes after Tadpole system fixation, the rate of spinal fusion, the incidence of adjacent segment degeneration, the rate of instrumentation failure, and the overall complications.
  
  
  METHODS
  Sixty patients who underwent posterolateral spinal fusion using the Tadpole system, in whom a radiograph of the lumbar spine was taken at more than 5 years after operation, were involved in this study. The improvement rate of the Japanese Orthopaedic Association (JOA) score, rate of spinal fusion, presence or absence of adjacent segment degeneration, rate of instrumentation failure, and postoperative complications of each patient were assessed at 5 years postoperatively.
  
  
  RESULTS
  The mean JOA score improvement was 72.5%, and the posterolateral spinal fusion rate was 93.3% (56 of 60 patients) at the last follow-up. Adjacent segment degeneration occurred in only two patients who showed decreased intervertebral disc height, and instrumentation failure (hook deviation) was observed in one patient. No other complications were observed in any patients.
  
  
  CONCLUSIONS
  Tadpole system fixation shows favorable long-term clinical outcomes.
authors.forename: Kriangkrai
authors.initials: K
authors.lastname: Wittayapairoj
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Wang
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sakakibara
authors.affiliation: Department of Spinal Surgery and Medical Engineering, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu city, Mie 514-8507, Japan. ykasai@clin.medic.mie-u.ac.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kasai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods / Q000639:trends*; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome