Mick J. Perez-Cruet M.D., M.S.
Namath Syed Hussain M.D.
Joseph John Joshua MSE
Evan Begun B.S.
Department of Neurosurgery, Oakland University William Beaumont, School of Medicine, Royal Oak, Michigan
The efficacy of minimally invasive (MI) spine fusion methods in improving disc height and its effect on Health-related Quality of Life (HRQL) measures was studied. The interbody device Staxx XD which is inserted at a height of 7mm and can expand to 15mm was evaluated.
Methods. 43 patients underwent minimally invasive transforminal lumbar interbody fusion (MITLIF) using the Staxx XD expandable interbody device. Preoperative and postoperative morphometric data (intervertebral height, foraminal height, subluxation) was collected based on plain radiographs. A validated full set of Health-related Quality of Life (HRQL) Measures, including Visual Analog Scale(VAS), Oswestry Disability Index (ODI), and SF-36 were also collected preoperativelyand postoperatively.
Results. Preoperative disc height increased from 6.7mm (range 2.5 – 12.8mm, SD=2.3mm) to 10.9mm postoperatively (range 8.3 – 15mm,SD=1.6mm, p value <0.0001). Preoperative foraminal height increased from 20.0mm (range 14.5 –26.8mm, SD=4.4mm) to 24.1mm postoperatively(range 15.5 – 32.3mm,SD=4.6mm, p value <0.01). Preoperative subluxationdecreased from 9.9mm (range4.5 – 24.7mm, SD=5.8mm) to 4.6mm postoperatively(range 0 – 7.2mm,SD=2.6mm, p value < 0.1). Successful fusion was achieved in >95% of patients based on postoperative dynamic radiographs at 3 month interval. Noneurological complication occurred. No electromyographic (EMG) activity was noted with implant insertion and disc height restoration. Statistically significant improvements in ODI, and SF-36 scores were reported starting at 3 months postoperatively.
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