Grob Mannion
Fakultäten » Medizinische Fakultät » Rheumaklinik und Institut für physikalische Medizin » PD Dr. Anne Mannion » Grob Mannion
Completed research project
| Title / Titel | Long-term patient-oriented outcome after translaminar screw fixation of the lumbar spine | ||||||
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| Abstract (PDF, 14 KB) | |||||||
| Summary / Zusammenfassung | INTRODUCTION Translaminar screw fixation represents an alternative operative technique to transpedicular fixation systems for short segment lumbar fusion. The method has been in use for more than twenty years, but few studies reporting the long-term outcome are to be found in the literature. This study sought to evaluate the long-term results after translaminar screw fixation of the lumbar spine in a large group of patients and to identify predictors of a good outcome. METHODS The Core Outcome Measures Index, a multidimensional outcome questionnaire, was sent to 646 consecutive patients who had undergone lumbar fusion with translaminar screws between 1987 and 2004, for various degenerative conditions of the lumbar spine. Patients also rated the global outcome and their satisfaction with treatment. Disc height was measured from preoperative radiographs using the distortion compensated roentgen analysis (DCRA) method. Multiple logistic regression analysis was used to identify factors associated with a good outcome. RESULTS 479 patients (74%) completed and returned the questionnaire. The average follow-up period was 10 years (range 2 - 20 years). 354/479 patients (74%) reported that the operation had either “helped a lot” or “helped” (=good outcome); 125/479 patients (26%) declared that it “helped only little”, “didn’t help” or “made things worse” (=poor outcome). Controlling for potential confounders, a preoperative disc height <80% of that reported for a normal population was the most significant unique predictor of a good outcome (OR=15.11, CI 95% 7.18 – 31.78, P<0.0001). DISCUSSION Translaminar screw fixation is a straightforward and effective technique for short segment fusion in the lumbar spine. For patients with a strict indication for spondylodesis, intact posterior elements (lamina and facets) and a low preoperative disc height, translaminar screw fixation represents a very successful fixation technique in the lumbar spine with good long-term results. | ||||||
| Publications / Publikationen | Aepli M, Mannion AF, Grob D (2009) Translaminar screw fixation of the lumbar spine: long-term outcome. Patient-oriented outcome in 476 cases after an average of 10 years. Spine 34(14):1492-8 | ||||||
| Keywords / Suchbegriffe | spinal fusion, translaminar fixation, outcome, long-term follow-up | ||||||
| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
Foundation Stiftung Wilhelm Schulthess Forschungsfonds |
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| Duration of Project / Projektdauer | May 2006 to Mar 2009 |