The correlation of intraoperative distraction of intervertebral disc with the postoperative canal and foramen expansion following oblique lumbar interbody fusion
- 22 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Spine Journal
- Vol. 30 (1), 151-163
- https://doi.org/10.1007/s00586-020-06604-3
Abstract
Purpose To examine the correlation of intraoperative distraction of intervertebral disc with the postoperative central canal and foramen expansion by oblique lumbar interbody fusion (OLIF) with indirect decompression. Methods Patients who underwent OLIF between October 2013 and April 2017 were included. Clinical outcomes included back and leg pain evaluated by visual analog scale (VAS) and Oswestry Disability Index (ODI). Intraoperative radiographic parameters of height ratio [(HR) = disc height/intervertebral body height)] and cage location were evaluated on intraoperative fluoroscopic images. Disc height (DH), foraminal height (FH), cross-sectional area of spinal canal (CSAC), and CSA of the foramen (CSAF) were measured. Results A total of 47 patients involving 62 levels were enrolled in this study. Mean follow-up was 43.8 ± 12.0 months. These patients reported an improvement of 61.7% in VAS back, 68.1% in VAS leg, and 46% in ODI (all p < 0.01). Radiographic parameters including HR, DH, FH, CSAC, and CSAF were also significantly increased by 32.6%, 48.2%, 21.4%, 44.0%, and 40.1% (left-side CSAF) or 45.4% (right-side CSAF), respectively (p < 0.05). HR increment was correlated with CSA (canal and foramen) increment. Slightly higher improvements of HR, DH, FH, CSAC, and CSAF (both sides) were noted when cage was located at middle rather than anterior (p > 0.05). Conclusions The ligamentotaxis effect of OLIF is capable of supporting indirect decompression of central canal and neural foramina and clinical improvement. HR is a reliable intraoperative assessment method. In addition, intraoperative HR increment was correlated with postoperative neural elements expansion.Keywords
This publication has 24 references indexed in Scilit:
- Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesisEuropean Spine Journal, 2015
- Anterior lumbar interbody fusion versus transforaminal lumbar interbody fusion – systematic review and meta-analysisBritish Journal of Neurosurgery, 2015
- Comparison of the different surgical approaches for lumbar interbody fusionJournal of Clinical Neuroscience, 2015
- Effect of Indirect Neural Decompression Through Oblique Lateral Interbody Fusion for Degenerative Lumbar DiseaseSpine, 2015
- Indirect foraminal decompression after lateral transpsoas interbody fusionJournal of Neurosurgery: Spine, 2012
- Evaluation of Indirect Decompression of the Lumbar Spinal Canal Following Minimally Invasive Lateral Transpsoas Interbody Fusion: Radiographic and Outcome Analysismin - Minimally Invasive Neurosurgery, 2011
- A Radiographic Assessment of the Ability of the Extreme Lateral Interbody Fusion Procedure to Indirectly Decompress the Neural ElementsSpine, 2010
- Comparison of One-Level Posterior Lumbar Interbody Fusion Performed With a Minimally Invasive Approach or a Traditional Open ApproachSpine, 2007
- A New Microsurgical Technique for Minimally Invasive Anterior Lumbar Interbody FusionSpine, 1997
- Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment.Radiology, 1987