الفهرس | Only 14 pages are availabe for public view |
Abstract This study aimed to assess the clinical and radiological results of treatment of 30 adult patients suffering from symptomatic degenerative lumbar disc disease with unilateral radiculopathy by interbody fusion using single cage supplemented by unilateral pedicle screw-rod system fixation. The indications for surgery were failure of response to conservative treatment for more than six months, or the presence or development of motor neurological deficits. This study is a thesis study composed of ( ) papers divided over five chapters : *The first one is composed of an introduction to our study and aim of our work. *The second one contains the review of literature in the form of anatomy and biomechanics related to our technique. *The third one contains the patients and methods. *The fourth one contains the results and methods of assessment(the modified Prolo system, the Visual analogue scale, and the Brantigen stiffe grading system). *The fifth one contains our Cases presentation. *The sixth one represents the discussion which contains an analysis of our results that resulted in 3 complications : -2 cases of superficial infection that were treated conservatively -1case of cage subsidence that was treated by a revision surgery otherwise all the cases showed dramatic improvement in there modified Prolo and Visual analogue scores , a comparison of our results with the results of different schools of medicine: the south American school of medicine, European school of medicine , and the Asian school of medicine (which included 2 studies), limitations of our study, future plans, a conclusion in which we came out with the decision that unilateral pedicular fixation combined with transforaminal lumbar interbody fusion is a viable method of treatment of degenerative lumbar disc disease that successfully achieves direct and indirect decompression of the exiting nerve root , and finally an English and an Arabic summary of the study. In conclusion: 1- Unilateral PS instrumented TLIF is a viable treatment option for treating Degenerative disc disease as it successfully achieves: a- Direct decompression through hemilaminictomy and inferior facetectomy b- Indirect decompression through restoration of the normal disc height by insertion of the cage . and hence addressing the main pathology which is the nerve root compression. c- One stage circumferential fusion through achieving interbody fusion and posterolateral fusion . 2-UNI-TLIF produces good results especially in terms of operative time, blood loss, implant costs, and hospital time for single or double-level diseases. 3- UNI-TLIF should be extended to include other inclusion criteria. 4-An improved study design and longer period of follow-up are still needed to confirm this effect. |