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KMID : 1150320160120020248
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Journal of Korean Society of Geriatric Neurosurgery
2016 Volume.12 No. 2 p.248 ~ p.252
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Surgical Outcomes of TLIF with Bone Cement Augmentation for Elderly Osteoporotic Spinal Stenosis
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Lee Ji-Hun
Park Jong-Tae
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Abstract
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Objective: The purpose of this study was to determine the efficacy of transforaminal lumbar interbody fusion (TLIF) with bone cement augmentation for elderly patient with lumbar spinal stenosis and osteoporosis.
Methods: Fourteen patients' medical records and radiographic findings were reviewed and postoperative outcome was assessed using modified Macnab criteria. TLIF and pedicle screw fixation with cement augmentation through pedicle screw have been performed at one or two-level lumbar spinal stenosis.
Results: Thirteen patients were female. Mean age of all patients was 73.1 years old. The mean follow-up period was 15 months. The mean pain scores (VAS) prior to surgery was 7.5±0.52 which decreased to 2.57±0.98 at 14 days after surgery. At final follow-up, according to modified Macnab criteria, 11 of 14 cases were satisfactory result (excellent and good). At final follow-up, the clinical outcome showed excellent in 3 patients (21.4%), good in 8 (57.1%), and fair in 3 (21.4%). No patient developed spinal instability.
Conclusion: In the management of lumbar spinal stenosis in patients with severe osteoporosis, TLIF with bone cement augmentation is effective and good procedure to reduce the clinical symptoms and complete fusion. Authors suggest that PMMA can become a helpful option to gain successful clinical outcome in case of pedicle screw fixation for osteoporotic lumbar spine.
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KEYWORD
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Spinal stenosis, TLIF, Osteoporosis, Bone cement, Spinal fusion
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