Spinal Canal Remodeling and Indirect Decompression of Contralateral Foraminal Stenosis After Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion
Objective There is a lack of literature on indirect decompression in uniportal endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF). Our aim is to evaluate the dimensions of the spinal canal and contralateral foramen before and after EPTLIF. Methods This is a retrospective study...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2023-03-01
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| Series: | Neurospine |
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| Online Access: | http://e-neurospine.org/upload/pdf/ns-2346132-066.pdf |
| _version_ | 1797329538338783232 |
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| author | Pang Hung Wu Eugene Tze-Chun Lau Hyeun-Sung Kim Giovanni Grasso Il-Tae Jang |
| author_facet | Pang Hung Wu Eugene Tze-Chun Lau Hyeun-Sung Kim Giovanni Grasso Il-Tae Jang |
| author_sort | Pang Hung Wu |
| collection | DOAJ |
| description | Objective There is a lack of literature on indirect decompression in uniportal endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF). Our aim is to evaluate the dimensions of the spinal canal and contralateral foramen before and after EPTLIF. Methods This is a retrospective study of patients who underwent EPTLIF in a tertiary spine centre over a 2-year period. The cross-sectional area of the spinal canal and the contralateral foramen at the level of fusion were measured on magnetic resonance imaging scan at 1-day postoperation and at the final follow-up. Patients were grouped according to the decompression performed as per the clinician’s judgement. Results One hundred fifty-two levels of fusion were performed in 120 patients. There was a statistically significant clinical improvement in visual analogue scale and Oswestry Disability Index scores postoperation. The measurements of the spinal canal area were 106.0 mm2, 138.8 mm2, and 195.5 mm2; while contralateral foraminal area were 73.2 mm2, 104.4 mm2, and 120.7 mm2 at preoperation, 1-day postoperation, and at the final follow-up, respectively (p < 0.001). For the subgroup analyses, spinal canal area measurements for the bilateral decompression cohort (n = 35) were 57.0 mm2, 123.9 mm2, and 191.8 mm2; for the ipsilateral decompression cohort (n = 42) were 89.3 mm2, 128.9 mm2, 183.3 mm2; and for the cohort without any decompression and only cage inserted (n = 75) were 138.3 mm2, 151.2 mm2, and 204.1 mm2 (p < 0.001). Contralateral foraminal area measurements were 73.3 mm2, 106.4 mm2 and 120.4 mm2 in the bilateral decompression cohort; 69.5 mm2, 99.0 mm2, 116.9 mm2 in the ipsilateral decompression cohort; and 75.1 mm2, 106.5 mm2, 122.9 mm2 in the cohort without any decompression (p < 0.001). Conclusion Indirect decompression of both the spinal canal and the contralateral foramen can be achieved via EPTLIF. Decompression on an asymptomatic contralateral side is not necessary. |
| first_indexed | 2024-03-08T07:06:53Z |
| format | Article |
| id | doaj.art-894b814b95a04b7fb37a1f5430371e1a |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:06:53Z |
| publishDate | 2023-03-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-894b814b95a04b7fb37a1f5430371e1a2024-02-03T04:29:36ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912023-03-012019910910.14245/ns.2346132.0661388Spinal Canal Remodeling and Indirect Decompression of Contralateral Foraminal Stenosis After Endoscopic Posterolateral Transforaminal Lumbar Interbody FusionPang Hung Wu0Eugene Tze-Chun Lau1Hyeun-Sung Kim2Giovanni Grasso3Il-Tae Jang4 National University Health System, Juronghealth Campus, Department of Orthopaedic Surgery, Singapore National University Health System, Juronghealth Campus, Department of Orthopaedic Surgery, Singapore Neurosurgical Clinic, Department of Biomedicine, Neurosciences and Advanced Diagnostics University for Palermo, Palermo, Italy Neurosurgical Clinic, Department of Biomedicine, Neurosciences and Advanced Diagnostics University for Palermo, Palermo, Italy Nanoori Gangnam Hospital, Spine Surgery, Seoul, KoreaObjective There is a lack of literature on indirect decompression in uniportal endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF). Our aim is to evaluate the dimensions of the spinal canal and contralateral foramen before and after EPTLIF. Methods This is a retrospective study of patients who underwent EPTLIF in a tertiary spine centre over a 2-year period. The cross-sectional area of the spinal canal and the contralateral foramen at the level of fusion were measured on magnetic resonance imaging scan at 1-day postoperation and at the final follow-up. Patients were grouped according to the decompression performed as per the clinician’s judgement. Results One hundred fifty-two levels of fusion were performed in 120 patients. There was a statistically significant clinical improvement in visual analogue scale and Oswestry Disability Index scores postoperation. The measurements of the spinal canal area were 106.0 mm2, 138.8 mm2, and 195.5 mm2; while contralateral foraminal area were 73.2 mm2, 104.4 mm2, and 120.7 mm2 at preoperation, 1-day postoperation, and at the final follow-up, respectively (p < 0.001). For the subgroup analyses, spinal canal area measurements for the bilateral decompression cohort (n = 35) were 57.0 mm2, 123.9 mm2, and 191.8 mm2; for the ipsilateral decompression cohort (n = 42) were 89.3 mm2, 128.9 mm2, 183.3 mm2; and for the cohort without any decompression and only cage inserted (n = 75) were 138.3 mm2, 151.2 mm2, and 204.1 mm2 (p < 0.001). Contralateral foraminal area measurements were 73.3 mm2, 106.4 mm2 and 120.4 mm2 in the bilateral decompression cohort; 69.5 mm2, 99.0 mm2, 116.9 mm2 in the ipsilateral decompression cohort; and 75.1 mm2, 106.5 mm2, 122.9 mm2 in the cohort without any decompression (p < 0.001). Conclusion Indirect decompression of both the spinal canal and the contralateral foramen can be achieved via EPTLIF. Decompression on an asymptomatic contralateral side is not necessary.http://e-neurospine.org/upload/pdf/ns-2346132-066.pdfspinal diseasesspinal stenosisendoscopyspinal fusion |
| spellingShingle | Pang Hung Wu Eugene Tze-Chun Lau Hyeun-Sung Kim Giovanni Grasso Il-Tae Jang Spinal Canal Remodeling and Indirect Decompression of Contralateral Foraminal Stenosis After Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion Neurospine spinal diseases spinal stenosis endoscopy spinal fusion |
| title | Spinal Canal Remodeling and Indirect Decompression of Contralateral Foraminal Stenosis After Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion |
| title_full | Spinal Canal Remodeling and Indirect Decompression of Contralateral Foraminal Stenosis After Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion |
| title_fullStr | Spinal Canal Remodeling and Indirect Decompression of Contralateral Foraminal Stenosis After Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion |
| title_full_unstemmed | Spinal Canal Remodeling and Indirect Decompression of Contralateral Foraminal Stenosis After Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion |
| title_short | Spinal Canal Remodeling and Indirect Decompression of Contralateral Foraminal Stenosis After Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion |
| title_sort | spinal canal remodeling and indirect decompression of contralateral foraminal stenosis after endoscopic posterolateral transforaminal lumbar interbody fusion |
| topic | spinal diseases spinal stenosis endoscopy spinal fusion |
| url | http://e-neurospine.org/upload/pdf/ns-2346132-066.pdf |
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