Indirect foraminal decompression after lateral transpsoas interbody fusion.
Indirect foraminal decompression after lateral transpsoas interbody fusion.
复制标题
腰肌外侧融合术后间接椎间孔减压。
DOI：
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复制
发表时间：
2012
期刊：
影响因子：
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通讯作者：
A. Sama
中科院分区：
文献类型：
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作者：
C. Kepler;A. Sharma;Russel C. Huang;D. Meredith;F. Girardi;F. Cammisa;A. Sama
对象
OBJECT
Lateral transpsoas interbody fusion (LTIF) permits anterior column lumbar interbody fusion via a direct lateral approach. The authors sought to answer 3 questions. First, what is the effect of LTIF on lumbar foraminal area? Second, how does interbody cage placement affect intervertebral height? And third, how does the change in foraminal area and cage position correlate with changes in Oswestry Disability Index (ODI) and 12-Item Short Form Health Survey (SF-12) scores?
METHODS
Included patients underwent LTIF with or without posterior instrumentation and received preoperative and postoperative CT scans. Disc heights, neural foraminal area between adjacent-level pedicles, and anteroposterior cage position were measured from sagittal CT images. Preoperative and postoperative ODI and SF-12 scores were matched with the change in foraminal area from the clinically most severely affected side for analysis of the relationship between outcomes instruments and change in foraminal area.
RESULTS
Average foraminal area increased by 36.2 mm(2), or 35% of the preoperative area (p < 0.01), without statistically significant differences by side, level, or anteroposterior cage position. Preoperative anterior and posterior disc heights measured 6.2 mm and 3.7 mm, respectively, compared with postoperative measurements of 9.8 mm (p < 0.01) and 6.3 mm (p < 0.01), respectively, without significant differences by level or cage position. Despite significant overall improvement in ODI and SF-12 scores, there was no correlation with foraminal area increase.
CONCLUSIONS
Average foraminal area increased approximately 35% after cage placement without variation based on cage position. While ODI and SF-12 scores increased significantly, there was no significant association with cage position or foraminal area change, likely attributable to the multifactorial nature of preoperative pain.