Papers by damandeep singh
Indian Journal of Orthopaedics, Dec 1, 2014
Background: The use of minimally invasive surgical (MIS) techniques represents the most recent mo... more Background: The use of minimally invasive surgical (MIS) techniques represents the most recent modification of methods used to achieve lumbar interbody fusion. The advantages of minimally invasive spinal instrumentation techniques are less soft tissue injury, reduced blood loss, less postoperative pain and shorter hospital stay while achieving clinical outcomes comparable with equivalent open procedure. The aim was to study the clinicoradiological outcome of minimally invasive transforaminal lumbar interbody fusion. Materials and Methods: This prospective study was conducted on 23 patients, 17 females and 6 males, who underwent MIS-transforaminal lumbar interbody fusion (TLIF) followed up for a mean 15 months. The subjects were evaluated for clinical and radiological outcome who were manifested by back pain alone (n = 4) or back pain with leg pain (n = 19) associated with a primary diagnosis of degenerative spondylolisthesis, massive disc herniation, lumbar stenosis, recurrent disc herniation or degenerative disc disease. Paraspinal approach was used in all patients. The clinical outcome was assessed using the revised Oswestry disability index and Macnab criteria. Results: The mean age of subjects was 55.45 years. L4-L5 level was operated in 14 subjects, L5-S1 in 7 subjects; L3-L4 and double level was fixed in 1 patient each. L4-L5 degenerative listhesis was the most common indication (n = 12). Average operative time was 3 h. Fourteen patients had excellent results, a good result in 5 subjects, 2 subjects had fair results and 2 had poor results. Three patients had persistent back pain, 4 patients had residual numbness or radiculopathy. All patients had a radiological union except for 1 patient. Conclusion: The study demonstrates a good clinicoradiological outcome of minimally invasive TLIF. It is also superior in terms of postoperative back pain, blood loss, hospital stay, recovery time as well as medication use.
Journal of Clinical Neuroscience, 2012
The purpose of this study was to assess the clinical and radiological outcomes of minimally invas... more The purpose of this study was to assess the clinical and radiological outcomes of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) surgery for lumbar spondylolisthesis. A prospective analysis was conducted of 23 consecutive patients with grade I or grade II lumbar spondylolisthesis who underwent a MI-TLIF using image guidance between August 2008 and September 2010. The patient group comprised 13 males and 10 females (mean age 57 years), 22 of whom underwent single level fusion and one patient with a two level fusion. All patients underwent postoperative CT scans to assess pedicle screw and cage placement and fusion at six months. The Oswestry Disability Index (ODI) scores were recorded preoperatively and at the six-month follow-up. We found that 22 of 23 (95.7%) patients showed evidence of fusion at six months with a mean improvement of 26.7 on ODI scores. The mean length of hospital stay was four days. The mean operative time was 172 minutes. Anatomical reduction of the spondylolisthesis was complete in 16 patients and incomplete in seven. Regarding complications, we observed: one of 94 (1.1%) pedicle screws misplaced, which did not require revision postoperatively; one of 23 patients (4.3%) with a pulmonary embolism and one of 23 (4.3%) patients with transient nerve root pain. There were no occurrences of infection and no postoperative cerebrospinal fluid leaks. We conclude that MI-TLIF offers patients a safe and effective surgical option for lumbar spondylolisthesis treatment. Furthermore, it may offer patients additional advantages in terms of postoperative pain and recovery.
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Papers by damandeep singh