Article Figures & Data
Figures
- Figure 1
Photograph showing lumbar spine with pedicles marked on the skin per anteroposterior fluoroscopy. A linear mark is then made connecting the lateral edge of the pedicles.
- Figure 2
(a) Photograph of Dynesys implanted via the midline approach in cases where a decompression was performed. (b) Photograph of Dynesys implanted via musclesparing approach.
- Figure 3
Graph showing TIS significantly improved at 6 weeks for patients who underwent posterior nonfusion stabilization via paraspinal muscle-sparing approach versus the midline muscle-stripping approach.
- Figure 4
Illustration showing the modified Wiltse muscle-sparing approach. Note the approach between the multifidus and longissimus muscles.
- Figure 5
(a), (b), (c). T2 weighted MRI of patients showing changes in the paraspinal muscles of a patient undergoing posterior nonfusion stabilization via the anatomy-preserving muscle-sparing approach vs (d), typical changes seen in a midline muscle stripping approach. Note the extensive high signal seen in the paraspinal muscles of the patient undergoing the midline approach.
Tables
Midline (n = 42) Paraspinal (n = 46) Age 48 (32 to 79) 43 (24 to 69) Male/Female 19/23 24/22 W/C 0 0 Smokers 0 0 Previous surgery 21 26 Note. W/C = Workers’ Compensation
Midline Paraspinal Spondylolisthesis 28 2 Retrolisthesis 12 0 Lateral/central stenosis (Overlapping diagnosis) 40 0 Dynamic foraminal stenosis 0 6 DDD 0 36 Adjacent to fusion 2 2 Note. DDD = degenerative disc disease
Midline (n = 42) Paraspinal (n = 46) Operative time 150 (120 – 240) 120 (90 – 180) Hospital stay 2.6 days (1 to 5 days) 1.8 days (1 to 3 days) Blood loss 350 (100 – 500) 300 (50 – 400) Levels stabilized One 15 16 Two 23 26 Three 4 4 Follow-up 18 months (12 months to 36 months) - Table 4
VAS, ODI and SF-36 Physical Component Scores in Patients Undergoing Posterior Nonfusion Stabilization
VAS Scores ODI SF-36 Physical Component Score Midline Paraspinal P value Midline Paraspinal P value Midline Paraspinal P value Pre-op 65 90 55 68 34 28.56 6 weeks 35.62 30 0.64 50 50 0.50 30.38 30.38 0.50 3 months 30.63 20 0.82 29.1 25 0.62 36.78 36.78 0.42 6 months 30.81 25 0.93 25.6 25 0.62 36 36 0.39 12 months 24 20 0.98 20.2 20 0.61 38 35.4 0.21 18 months 22 25 0.95 22 22 0.60 38 34 0.09 2 years 24 22 1.00 20.4 22 0.52 36 34 0.05 Note. ODI—Oswestry Disability Index; VAS—Visual Analog Scale.
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