Document Type : Original Article
Authors
1
Department of orthopedic surgery
2
department of orthopedic surgery and traumatology, Al Azhar University, Egypt
3
department of orthopedic surgery and traumatology, faculty of medicine, Minia University.
4
assistant professor of Orthopedic Surgery & Traumatology Faculty of Medicine - Minia University
Abstract
Background context: Restenosis, pseudoarthrosis, implant complications, infection, adjacent segment problems, and flat back deformity are among the indications for revision spine surgery (RSS), which occurs in 8–45% of cases after primary spinal fusion procedures. Different surgical techniques for RSS are controversial, and selecting the right patient and technique is crucial to achieving a satisfactory outcome in RSS.
Study design: Retrospective single-center clinical study.
Purpose: The aim was to retrospectively evaluate the posterior transforaminal neural decompression fusion (PTNDF) results in patients needing RSS.
Patients and methods: From 2018 to 2022, 50 patients who had undergone complex spinal fusion surgery and were experiencing uncontrollable back and leg pain were treated with PTNDF surgery. The PTNDF procedure involved either costotransverscetomy in the thoracic segments or facetectomy in the lumbar spine, neuroforaminal decompression, anterior reconstruction, and correction of profile imbalance with transpedicular fixation through only the posterior approach. Patients were examined and followed up clinically {pain (visual analog scale VAS), neurological deficit (American Spinal Injury Association Impairment Scale (AIS), functionally {Oswestry disability index (ODI) and modified Prolo scales}, and radiologically (deformity correction, lumbopelvic data, slippage reduction, and fusion time). Perioperative outcomes and complications were documented.
Results: Clinical, radiological, and functional outcomes were significantly improved. 95% of patients had bony fusion. One patient had permanent neurological deficits. Four cases developed adjacent segment problems, either degeneration or instability, at the final stage.
Conclusion: The PTNDF technique is an effective tool in RSS that combines neural decompression, correction of sagittal and coronal profiles, and functional improvement
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