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Abstract
Objectives
To compare the changes of dimensions of the intervertebral disc and neural foramen between the anterior lumbar interbody fusion and the posterolateral fusion in the lumbar spine.
Summary of Literature Review
There are few reports comparing an anterior lumbar interbody fusion with pedicle screw fixation and a posterolateral fusion with pedicle screw fixation.
Materials and Methods
We studied 62 patients with degenerative lumbar diseases who underwent minimal anterior lumbar interbody fusion with pedicle screw fixation (group I, 40 patients) or who underwent posterolateral fusion with pedicle screw fixation (group II, 22 patients). We measured the height of disc and the height, width, and area of the neural foramen measured in 1-mm reconstructive sagittal images of computed tomography before and 6 months after the operation. The factors were independently measured by three different observers.
Results
Disc height was increased by a mean of 39.1±3.28% in group I and 3.1±2.99% in group II. The height of the neural foramen was increased by a mean of 18.7±4.21% in I and 1.0±2.34% in II. The area of neural foramen was increased by a mean of 21.5±3.50% in I and -2.1±4.39% in II, with significant differences between groups in all parameters.
REFERENCES
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Figures and Tables%
Fig. 1.
Schematic picture for CT measurement were done via sagittal reconstruction at the level of the mid pedicle on axial CT cut
Fig. 2.
Diagram showing the measurements made on the discs and neuroforamina. a : anterior disc height, b : posterior disc height, c : neuroforminal height
Fig. 3.
A 62-year-old woman with spinal stenosis on L4-5 that treated anterior interbody fusion with pedicle screw fixation. (A) Left side sagittal reconstruction image of preoperative CT scan (B) Left side sagittal reconstruction image of seven-month postoperative CT scan shows marked increase of the disc height, width and area of neural foramen.
Fig. 4.
A 65-year-old woman with spinal stenosis on L4-5 that treated posterolateral fusion with pedicle screw fixation. (A) Left side sagittal reconstruction image of preoperative CT scan (B) Left side sagittal reconstruction image of six-month postoperative CT scan shows slight decrease of the posterior disc height, width and area of neural foramen.
Table 1.
Changes of anatomical parameters and statistical results by paired t-test after anterior interbody fusion with pedicle screw fixation or posterolateral fusion with pedicle screw fixation.
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