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SURGICAL OUTCOMES OF TRANSFORAMINAL LUMBAR INTERBODY FUSION (TLIF) FOR PATIENTS WITH OSTEOPOROTIC L4L5 SPONDYLOLITHESIS USING FENESTRATED CEMENT-AUGMENTED SCREWS AT VIET DUC HOSPITAL
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Abstract
Objective: To evaluate the outcomes of transforaminal lumbar interbody fusion (TLIF) surgery for L4L5 spondylolisthesis patients with osteoporosis using fenestrated cement-augmented screws at Viet Duc Hospital. Methods: A prospective descriptive study was conducted with 30 patients with lumbar spondylolisthesis and osteoporosis who underwent TLIF surgery using fenestrated cement-augmented screws at Viet Duc Hospital from January 2022 to June 2023. Results: Among the 30 patients in our study, the average surgery time was 79.9 ± 12.9 minutes. The average blood loss was 267.0 ± 46.9 ml. The average amount of cement injected into each vertebra was 3.0 ± 1.2 ml. The average hospital stay was 5.6 ± 1.8 days. Postoperatively, patients experienced a significant reduction in vertebral slippage and an improvement in interbody height compared to preoperative measurements, with p<0.05. At 12 months post-surgery, the decrease in interbody height compared to 1 month post-surgery was not statistically significant, with p>0.05. Patients' neurological symptoms significantly improved at 1, 6, and 12 months post-surgery. The VAS scores for lumbar spine and leg pain, as well as ODI scores, significantly decreased at 1, 6, and 12 months post-surgery, with a confidence level of P < 0.01. Immediately after surgery, only one patient (3.3%) developed a urinary tract infection, and one patient (3.3%) experienced superficial wound infection. At 12 months post-surgery, the screw loosening rate was 3.3%, and adjacent segment disease was 1.3%. The bone fusion rate was 80.0%, with no cases of non-union. Conclusion: TLIF surgery for L4L5 spondylolisthesis patients with osteoporosis using fenestrated cement-augmented screws is clinically effective, significantly improving VAS and ODI scores, achieving good correction outcomes, and demonstrating a high bone fusion rate. The rates of screw loosening and dislodgement are low, as are cement leakage and postoperative complications.
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Keywords
Lumbar spondylolithesis, osteoporotic, transforaminal lumbar interbody fusion (TLIF), fenestrated cement-augmented screws
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