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Vol. 11. Issue 6.
Pages 409-418 (January 2000)
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Vol. 11. Issue 6.
Pages 409-418 (January 2000)
The Omega 21 spinal fixator. Analysis of the results in pedicle instrumented lumbar fusion after a two year postoperative follow up
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J. Barberá
Department of Neurosurgery and Spine Surgery. Hospital General Universitario. Valencia. Spain
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Summary

A retrospective unicentre study of the first 300 patients implanted with the Omega 21 spinal fixator was performed to analyse the efficacy and safety of the system in the treatment of spinal disorders in which instrumented arthrodesis is indicated. In all cases the follow-up was over two years.

The implant was used in patients with herniated disc, degenerative and isthmic spondylolisthesis, lumbar stenosis, degenerative scoliosis, congenital deformities, postoperative instability, fractures and vertebral tumors. 277 patients were available for evaluation of clinical and self assessed results and complications. In 254 fused cases radiographic information was used to analyse the presence of bone fusion and loss of reduction.

In 83.3% of cases the clinical result was good. 64.8% of employed patients returned to their previous jobs and 70.4% resumed their pre-morbid level of activity.

Fusion was successful in 89.8% of cases. Twenty-eight of the 33 patients with bone problems (osteoporosis and reoperations) had successful fusion. No significant differences were found in patients with more than one fused segment.

Complications were seen in 27.1% and were generally associated with major surgery, and usually irrelevants. Only 3.6% of the complications were implant related.

In conclusion the Omega 21 spinal fixator provides good stabilisation for graft consolidation, with minimum inherent risk and the added advantage that it can be used in patients with osteoporosis and in reoperations.

Key Words:
Spinal arthrodesis
Spinal fusion
Thoracolumbar fusion
Pedicle instrumentation
Spinal fixator
Resumen

Estudio retrospectivo, unicéntrico, de los primeros 300 pacientes operados con el fijador vertebral Omega 21 realizado con el propòsito de valorar la eficacia y seguridad del fijador en el tratamiento de la patología que requiere artrodesis vertebral. En todos los casos la evolución postoperatoria era de dos afios o superior.

El sistema se utilizó en hernia de disco, espondilolistesis degenerativa e ístmica, estenosis del canal lumbar, escoliosis degenerativa, deformidades congénitas, inestabilidad postoperatoria, fracturas y tumores vertebrales malignos. En 277 casos se consiguió hacer una evaluación de los resultados clínicos y subjetivos y de las complicaciones de la técnica. En 254 casos se obtuvo una valoración radiográfica de la fusion ósea.

Los resultados demuestran que en el 83.3% de los casos el resultado clínico fue bueno. Un 64.8% se reintegró a su trabajo remunerado previo y un 70.4% consiguió un nivel de vida similar al premórbido. En 89.8% se obtuvo la artrodesis objeto de la cirugía. En 33 pacientes en los que las condiciones para conseguir artrodesis no eran optimas (osteoporosis y reintervenciones), se obtuvo una fusión documentada en 28. No se apreciaron diferencias significativas de la artrodesis en casos con más de un segmento instrumentado

Se observó un 27.1% de complicaciones, la mayoría de tipo generai e irrelevantes. Solo un 3.6% estuvo relacionada específicamente con el implante.

Se llega a la conclusión de que el Omega 21 consigue resultados similares a los de otros fijadores del mercado con la ventaja de poder ser utilizado en casos de osteoporosis y reintervenciones.

Palabras Clave:
Fusion vertebral
Artrodesis vertebral
lnstrumentacion pedicular
Fijador vertebral

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