Study design Prospective, observational. Objectives The aim of our study was to assess the amount of reduction in lean muscle mass (LMM) of multifidus muscle (MFM) between conventional open Transforaminal lumbar interbody fusion (CO-TLIF) as compared to Minimally invasive spine Transforaminal lumbar interbody fusion (MIS-TLIF). Methods This study was conducted between 2017 and 2020. It included 100 patients divided into two groups, 50 patients treated with CO-TLIF, 50 treated with MIS-TLIF. Only patients undergoing single level, primary lumbar fusion at L4-5 or L5-S1 level for degenerative pathologies were included. All patients were assessed by magnetic resonance imaging (MRI) scans 1-year post surgery. Measurements were performed using ImageJ image processing program. Results Mean percentage reduction in LMM in CO-TLIF group was 45.52 ± 12.36% and MIS-TLIF group was 25.83 ± 9.64% [statistically significant (t = 8.78, P < .001)]. Mean percentage reduction in LMM on side of cage insertion was 39.63 ± 15.96% and opposite side was 31.40 ± 15.01% [statistically significant (t = 9.06, P < .001)]. Mean reduction of LMM among males was 29.38 ± 15.23% and females was 40.42 ± 12.67% [statistically significant (t = −3.95, P < .001)]. We observed significant but weak degree of correlation between age and percentage reduction of LMM (r = .22, P = .028). Conclusion Mean reduction in LMM was greater in CO-TLIF group as compared to MIS-TLIF. There was greater reduction in LMM in females and on side of cage insertion. We also found greater reduction in LMM with increasing age in both groups.
Background
Congenital spinal pedicle agenesis is rare. The majority of cases are asymptomatic. Few present with either low back pain or radiculopathy. Pedicle screw insertion may pose difficulties in view of abnormal anatomy.
Case presentation
Between Jan 2005 and March 2021, all the data were retrospectively reviewed for the cases operated for congenital anomalies. Three such cases were operated. Case 1 had bilateral agenesis of L5 vertebra with an ectopic kidney in right iliac fossa, absent uterus, absent ovaries and vaginal atresia. Case 2 had absent S1 pedicle with conjoint left L5 nerve root. Case 3 had hypoplastic left L5 pedicle, contained disc herniation, facetal arthropathy. Pedicle screws were placed using O-arm and navigation.
Conclusion
Pedicle agenesis increases the difficulty in pedicle screw fixation and fusion. Anomalous facet and conjoint nerve root need to be looked for intraoperatively. Use of O-arm and CT navigation is of great help in getting safe and accurate anchor points for screw placement avoiding neurological injury.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.