Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression Surgery
Study Design Retrospective comparative study. Purpose We compared clinical and radiographical outcomes after lumbar decompression revision surgery for restenosis by lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF). Overview of Literature Indirect lumbar decompressi...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2020-06-01
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| Series: | Asian Spine Journal |
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| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2019-0194.pdf |
| _version_ | 1818136534560276480 |
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| author | Hiroaki Nakashima Tokumi Kanemura Kotaro Satake Kenyu Ito Yoshimoto Ishikawa Jun Ouchida Naoki Segi Hidetoshi Yamaguchi Shiro Imagama |
| author_facet | Hiroaki Nakashima Tokumi Kanemura Kotaro Satake Kenyu Ito Yoshimoto Ishikawa Jun Ouchida Naoki Segi Hidetoshi Yamaguchi Shiro Imagama |
| author_sort | Hiroaki Nakashima |
| collection | DOAJ |
| description | Study Design Retrospective comparative study. Purpose We compared clinical and radiographical outcomes after lumbar decompression revision surgery for restenosis by lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF). Overview of Literature Indirect lumbar decompression with LLIF was used to treat degenerative lumbar diseases requiring neural decompression. However, only a few studies have focused on the effectiveness of this technique for restenosis after lumbar decompression. Methods We retrospectively investigated 52 cases involving lumbar interbody fusions for restenosis with spondylolisthesis after lumbar decompressions; these cases consisted of 15 patients who underwent indirect decompression with LLIF and posterior fixation and 37 patients who underwent the same procedure with PLIF. We compared Japanese Orthopaedic Association (JOA) scores and perioperative complications between groups. The cross-sectional areas of the thecal sac on magnetic resonance imaging were measured before, immediately after, and 2 years after surgery. We conducted statistical analyses using unpaired t -test and Fisher’s exact tests, and a p-value <0.05 was considered statistically significant. Results The operative time was significantly shorter in the LLIF group than in the PLIF group (115.3±33.6 min vs. 186.2±34.2 min, respectively; p<0.001). In addition, the intraoperative blood loss was significantly lower in the LLIF group than in the PLIF group (58.2±32.7 mL vs. 303.2±140.1 mL, respectively; p<0.001). We found two cases of transient lateral thigh weakness (13.3%) in the LLIF group and five cases of incidental durotomy, one case of deep infection, and one case of neurological deterioration in the PLIF group—resulting in a higher complication incidence (18.9%), although it did not reach (p=0.63). The JOA scores improved significantly in both groups. Conclusions Indirect decompression using LLIF provided acceptable clinical and radiographical outcomes in patients with restenosis with spondylolisthesis after lumbar decompression; no revision-surgery-specific complications were found. Our results suggest that LLIF is a safe and minimally invasive procedure for revision surgery. |
| first_indexed | 2024-12-11T09:41:56Z |
| format | Article |
| id | doaj.art-3c092ae9afb242838bbc357404b4c70b |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-11T09:41:56Z |
| publishDate | 2020-06-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-3c092ae9afb242838bbc357404b4c70b2022-12-22T01:12:39ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462020-06-0114330531110.31616/asj.2019.01941147Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression SurgeryHiroaki Nakashima0Tokumi Kanemura1Kotaro Satake2Kenyu Ito3Yoshimoto Ishikawa4Jun Ouchida5Naoki Segi6Hidetoshi Yamaguchi7Shiro Imagama8 Department of Orthopedic Surgery, Konan Kosei Hospital, Konan, Japan Department of Orthopedic Surgery, Konan Kosei Hospital, Konan, Japan Department of Orthopedic Surgery, Konan Kosei Hospital, Konan, Japan Department of Orthopedic Surgery, Konan Kosei Hospital, Konan, Japan Department of Orthopedic Surgery, Konan Kosei Hospital, Konan, Japan Department of Orthopedic Surgery, Konan Kosei Hospital, Konan, Japan Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, JapanStudy Design Retrospective comparative study. Purpose We compared clinical and radiographical outcomes after lumbar decompression revision surgery for restenosis by lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF). Overview of Literature Indirect lumbar decompression with LLIF was used to treat degenerative lumbar diseases requiring neural decompression. However, only a few studies have focused on the effectiveness of this technique for restenosis after lumbar decompression. Methods We retrospectively investigated 52 cases involving lumbar interbody fusions for restenosis with spondylolisthesis after lumbar decompressions; these cases consisted of 15 patients who underwent indirect decompression with LLIF and posterior fixation and 37 patients who underwent the same procedure with PLIF. We compared Japanese Orthopaedic Association (JOA) scores and perioperative complications between groups. The cross-sectional areas of the thecal sac on magnetic resonance imaging were measured before, immediately after, and 2 years after surgery. We conducted statistical analyses using unpaired t -test and Fisher’s exact tests, and a p-value <0.05 was considered statistically significant. Results The operative time was significantly shorter in the LLIF group than in the PLIF group (115.3±33.6 min vs. 186.2±34.2 min, respectively; p<0.001). In addition, the intraoperative blood loss was significantly lower in the LLIF group than in the PLIF group (58.2±32.7 mL vs. 303.2±140.1 mL, respectively; p<0.001). We found two cases of transient lateral thigh weakness (13.3%) in the LLIF group and five cases of incidental durotomy, one case of deep infection, and one case of neurological deterioration in the PLIF group—resulting in a higher complication incidence (18.9%), although it did not reach (p=0.63). The JOA scores improved significantly in both groups. Conclusions Indirect decompression using LLIF provided acceptable clinical and radiographical outcomes in patients with restenosis with spondylolisthesis after lumbar decompression; no revision-surgery-specific complications were found. Our results suggest that LLIF is a safe and minimally invasive procedure for revision surgery.http://www.asianspinejournal.org/upload/pdf/asj-2019-0194.pdfindirect decompressionlateral lumbar interbody fusionreoperationposterior lumbar interbody fusiondural tear |
| spellingShingle | Hiroaki Nakashima Tokumi Kanemura Kotaro Satake Kenyu Ito Yoshimoto Ishikawa Jun Ouchida Naoki Segi Hidetoshi Yamaguchi Shiro Imagama Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression Surgery Asian Spine Journal indirect decompression lateral lumbar interbody fusion reoperation posterior lumbar interbody fusion dural tear |
| title | Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression Surgery |
| title_full | Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression Surgery |
| title_fullStr | Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression Surgery |
| title_full_unstemmed | Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression Surgery |
| title_short | Indirect Decompression Using Lateral Lumbar Interbody Fusion for Restenosis after an Initial Decompression Surgery |
| title_sort | indirect decompression using lateral lumbar interbody fusion for restenosis after an initial decompression surgery |
| topic | indirect decompression lateral lumbar interbody fusion reoperation posterior lumbar interbody fusion dural tear |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2019-0194.pdf |
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