Article Figures & Data
Figures
- Fig. 1
Telescopic instrument with the three stages for posterolateral transforaminal disk access.
- Fig. 2
Rigid PEEK cage fitting through a 12 mm access cannula (top) and same size expandable titanium cage, unexpanded (left) and fully expanded (right) (bottom).
- Fig. 3
Posterolateral transforaminal 18G needle insertion under anteroposterior and lateral fluoroscopic control.
- Fig. 4
Bevelled cannula protecting the exiting nerve root.
- Fig. 5
Intradiscal titanium cage expansion.
- Fig. 6
Postoperative fusion cage control by CT scan. Intradiscal rigid PEEK cage (left) and expanded titanium cage (right).
- Fig. 7
Percentages of patients with excellent, good, fair, and poor results in the overall series of patients and subgroups of patients undergoing PEEK cage insertion (group A), expandable titanium cage as primary surgery (group B), and expandable titanium cage as revision surgery (group C).
- Fig. 8
Final fluoroscopic anteroposterior and lateral control of the expandable titanium cage positioned at L4-L5 level.
- Fig. 9
Preoperative (left) and postoperative (right) CT scan showing distraction and reduction of a spondylolisthesis grade 1 at L5-S1 level.
- Fig. 10
Preoperative spondylolisthesis L5-S1 grade II-III (A). Postoperative reduction after Opticage™ expansion and posterior screw fixation (B). Evidence of bony fusion 24 months after surgery (C).
Tables
- Table 1
Characteristics of Patients Undergoing Percutaneous Transforaminal Lumbar Interbody Fusion (PTLIF)
Data Non-expandable PEEK interbody implant Expandable titanium interbody implant (n = 20) Total patients (n = 30) Primary surgery (group A) (n = 10) Primary surgery (group B) (n = 10) Revision surgery (group C) (n = 10) Sex Males 4 3 5 12 Females 6 7 5 18 Age, years, mean (SD) 61.4 (17.4) 59.9 (17.5) 65.5 (12.9) 62.2 (15.9) Total disks 10 11 10 31 Single level 10 10 10 30 Double level 0 1 0 1 L2-L3 0 1 1 2 L3-L4 2 0 1 3 L4-L5 6 6 5 17 L5-S1 2 4 3 9 Spinal diseases DDD 6 3 0 9 Spondylolisthesis 4 6 2 12 Failed arthrodesis 0 0 6 6 Instability after decompression 0 0 2 2 Chondroma 0 1 0 1 - Table 2
Individual Data of 10 Patients with Failed Back Surgery Syndrome Undergoing Percutaneous Transforaminal Lumbar Interbody Fusion (PTLIF)
Case Previous surgery Disk levels Diagnosis Treatment Fusion level 1 Posterior fixation 3 years ago L4-S1 Screw loosening Expandable cage L5-S1 2 Decompression 4 years ago and posterior fusion 2 years ago L2-L5 Broken bone graft + Spondylolisthesis L3-L4 Expandable cage + posterior re-fixation L2-L5 L3-L4 3 Percutaneous B-Twin fusion 6 years ago L5-S1 Failed arthrodesis Expandable cage + posterior re-fixation L4-S1 L5-S1 4 PLIF with posterior fixation and decompression 2 years ago L3-S1 Adjacent segment syndrome Expandable cage + posterior re-fixation D12-L3 L2-L3 5 Posterior decompression 1 year ago L4-S1 Flat back syndrome Expandable cage + posterior re-fixation L4-S1 L5-S1 6 Decompression with posterior fixation 3 years ago L3-L5 Screw loosening Expandable cage + posterior re-fixation L3-L5 L4-L5 7 Discectomy 17 years ago L4-L5 Foraminal stenosis Expandable cage + posterior re-fixation L3-S1 L4-L5 8 Posterior fixation with interbody PEEK cage 1 year ago L4-L5 Foraminal stenosis + spondylolisthesis Expandable cage L4-L5 9 Posterior fixation L1-L4 11 years ago and posterior fixation L1-L5 1 year ago L3-S1 Screw loosening Expandable cage + posterior re-fixation L4-S1 L4-L5 10 Posterior fixation + decompression 6 months ago L4-L5 Screw loosening Expandable cage + posterior re-fixation L4-L5 L4-L5 PLIF: posterior lumbar interbody fusion.
- Table 3
Results of Functional Assessments for Pain and Disability in 30 Patients Undergoing Percutaneous Transforaminal Lumbar Interbody Fusion (PTLIF).
Data Non-expandable PEEK interbody implant Expandable titanium interbody implant (n = 20) Total patients (n = 30) Primary surgery (group A) (n = 10) Primary surgery (group B) (n = 10) Revision surgery (group C) (n = 10) Back pain, VAS scores, mean Preoperatively 6.8 6.4 7.2 6.9 Postoperatively (first week) 4.2* 5.0* 4.9* 4.8* Follow-up (mo) 1 3.4* 3.2* 4.6* 3.7* 3 2.8* 2.2* 3.1* 2.6* 6 2.1* 1.5* 3.3* 2.3* 12 3.0* 1.5* 3.8* 2.5* 24 3.0* 0.9* 3.2* 2.4* Leg pain, VAS scores Preoperatively 7.2 7.3 7.4 7.4 Postoperatively (first week) 5.1* 3.7* 4.0* 4.1* Follow-up (mo) 1 3.7* 2.4* 3.0* 2.8* 3 2.3* 1.4* 1.7* 1.5* 6 1.7* 1.8* 1.0* 1.3* 12 1.3* 1.8 2.0* 1.4* 24 1.3* 0.2* 1.0* 0.8* ODI score, mean Preoperatively 31.9 33.3 35.4 34.2 Postoperatively (first week) 23.4* 25.4* 27.3* 25.3* Follow-up (monts) 1 17.4* 19.6* 22.3 19.4* 3 14.3* 15.0* 17.0* 14.7* 6 12.6* 12.8* 15.1* 13.0* 12 12.0* 11.5* 15.8* 12.0* 24 12.0* 11.2* 15.2* 12.8* ↵* P < 0.05 compared to preoperative values. VAS: visual analog scale. ODI: Oswestry Disability Index.
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