Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Posterior Thoracic Cage Interbody Fusion Offers Solid Bone Fusion with Sagittal Alignment Preservation for Decompression and Fusion Surgery in Lower Thoracic and Thoracolumbar Spine

  • Shin, Hong Kyung (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Moinay (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Sun Kyu (Department of Neurological Surgery, National Police Hospital) ;
  • Choi, Il (Department of Neurological Surgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Seo, Dong Kwang (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Jin Hoon (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Roh, Sung Woo (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeon, Sang Ryong (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2020.11.03
  • Accepted : 2021.03.19
  • Published : 2021.11.01
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Abstract

Objective : It is challenging to make solid fusion by posterior screw fixation and laminectomy with posterolateral fusion (PLF) in thoracic and thoracolumbar (TL) diseases. In this study, we report our experience and follow-up results with a new surgical technique entitled posterior thoracic cage interbody fusion (PTCIF) for thoracic and TL spine in comparison with conventional PLF. Methods : After institutional review board approval, a total of 57 patients who underwent PTCIF (n=30) and conventional PLF (n=27) for decompression and fusion in thoracic and TL spine between 2004 and 2019 were analyzed. Clinical outcomes and radiological parameters, including bone fusion, regional Cobb angle, and proximal junctional Cobb angle, were evaluated. Results : In PTCIF and conventional PLF, the mean age was 61.2 and 58.2 years (p=0.46), and the numbers of levels fused were 2.8 and 3.1 (p=0.46), respectively. Every patient showed functional improvement except one case of PTCIF. Postoperative hematoma as a perioperative complication occurred in one and three cases, respectively. The mean difference in the regional Cobb angle immediately after surgery compared with that of the last follow-up was 1.4° in PTCIF and 7.6° in conventional PLF (p=0.003), respectively. The mean durations of postoperative follow-up were 35.6 months in PTCIF and 37.3 months in conventional PLF (p=0.86). Conclusion : PTCIF is an effective fusion method in decompression and fixation surgery with good clinical outcomes for various spinal diseases in the thoracic and TL spine. It provides more stable bone fusion than conventional PLF by anterior column support.

Keywords

Acknowledgement

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI16C2188).

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