الفهرس | Only 14 pages are availabe for public view |
Abstract Fusion between lumber vertebrae is indicated when there is instability e.g: fracture pars (spondylolysis, spondylolithesis) or recurrent Disc herniation and surgeries need extensive removal of the lamina and facet bilaterally. The treatment modalities differ from simple medical treatment and physiotherapy to surgery and lumbar fixation. The goal of surgery is to decompress the neural elements and immobilize the unstable segment or segments of the spinal column. This is usually performed with elimination of motion across the facet joint and the intervertebral disc through arthrodesis. The decompressive procedure may have been sufficient to resolve the neural compression and that, independent of the correction of the overall spinal balance; the spinal immobilization may have reduced the soft-tissue stress. The fusion of the posterior lumbar elements combined with placement of instrumentation represents a valid solution for lumbar instability and may result in a solid fusion in up to 95% of cases. Improvements in surgical technique and instrumentation and a better understanding of the theoretical advantages of PLIF have greatly expanded the successful applications of the procedure. In our comparative study we achieved comparison between is pedicle screw fixation with lateral fusion alone in compare with pedicle screw fixation with lateral fusion and inter body fusion. Results indicate the efficacy of both types of fusion in stability with slightly higher incidence in pedicle screw fixation with inter body fusion, but pedicle screw fixation with inter body fusion still more time consuming in the theater and more blood loss in the operation and much more complication are resulted such as Dural tear and nerve root injury . |