Surgical Outcomes of TLIF with Bone Cement Augmentation for Elderly Osteoporotic Spinal Stenosis

, Jihun Lee; , Jongtae Park

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2016;12(2):248-252.
Published online September 30, 2016.

Surgical Outcomes of TLIF with Bone Cement Augmentation for Elderly Osteoporotic Spinal Stenosis

Jihun Lee , Jongtae Park

Department of Neurosurgery, Wonkwang University School of Medicine, Iksan, Korea

골다공증을 동반한 고령의 요추부 척추관 협착증 환자에서 골 시멘트 강화를 이용한 TLIF 수술의 결과

이지훈·박종태

원광대학교 의과대학 신경외과학교실

Abstract

Objective
The purpose of this study was to determine the efficacy of transforaminal lumbar interbody fusion (TLIF) with bone cement augmentation for elderly patient with lumbar spinal stenosis and osteoporosis.
Methods
Fourteen patients' medical records and radiographic findings were reviewed and postoperative outcome was assessed using modified Macnab criteria. TLIF and pedicle screw fixation with cement augmentation through pedicle screw have been performed at one or two-level lumbar spinal stenosis.
Results
Thirteen patients were female. Mean age of all patients was 73.1 years old. The mean follow-up period was 15 months. The mean pain scores (VAS) prior to surgery was 7.5±0.52 which decreased to 2.57±0.98 at 14 days after surgery. At final follow-up, according to modified Macnab criteria, 11 of 14 cases were satisfactory result (excellent and good). At final follow-up, the clinical outcome showed excellent in 3 patients (21.4%), good in 8 (57.1%), and fair in 3 (21.4%). No patient developed spinal instability.
Conclusion
In the management of lumbar spinal stenosis in patients with severe osteoporosis, TLIF with bone cement augmentation is effective and good procedure to reduce the clinical symptoms and complete fusion. Authors suggest that PMMA can become a helpful option to gain successful clinical outcome in case of pedicle screw fixation for osteoporotic lumbar spine.

Key Words: Spinal stenosis, TLIF, Osteoporosis, Bone cement, Spinal fusion