COMPARATIVE STUDY
JOURNAL ARTICLE

Anterior and posterior lumbar interbody fusion with percutaneous pedicle screws: comparison to muscle damage and minimally invasive techniques

Rob D Dickerman, John W East, Karl Winters, Jennifer Tackett, Annette Hajovsky-Pietla
Spine 2009 December 1, 34 (25): E923-5
19940722

STUDY DESIGN: Retrospective analysis of patients whom underwent one-level anterior lumbar interbody fusion or posterior lumbar interbody fusion with percutaneous pedicle screws.

OBJECTIVE: To determine which minimally invasive fusion technique, anterior or posterior lumbar fusions, induces the least amount of muscle damage.

SUMMARY OF BACKGROUND DATA: Creatine phosphokinase is recognized as a good marker for muscle damage occurring in patients after spine surgery. Minimally invasive fusions are known to reduce the amount of muscle damage. Which surgery induces the least amount of muscle damage is yet to be determined.Minimally invasive spine surgery is becoming increasing popular due to the benefits of less muscle damage, shorter hospital length and quicker recovery. Lumbar fusions are one of the most common surgeries and is becoming less invasive with the use of percutaneous pedicle screws.

METHODS: Seventy-four patients whom underwent either anterior or posterior lumbar interbody fusions with percutaneous pedicle screws had preoperative and postoperative creatine kinase levels. Statistical analysis then compared the average change between the 2 groups.

RESULTS: Minimally invasive anterior lumbar interbody fusions with percutaneous pedicle screws had significantly less muscle damage (P < 0.05) than minimally invasive posterior lumbar interbody fusions with percutanoues screws.

CONCLUSION: Minimally invasive anterior lumbar interbody fusions with percutaneous pedicle screws cause significantly less muscle damage than minimally invasive posterior lumbar interbody fusions with percutaneous screws. Furthermore minimally invasive anterior lumbar body interbody fusions demonstrated near the same amount of muscle damage to previously published literature on lumbar microdikectomies.

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