Radiological evaluation of fusion patterns after lateral lumbar interbody fusion: institutional case series

Proietti, Luca; Perna, Andrea; Ricciardi, Luca; Fumo, Caterina; Santagada, Domenico Alessandro; Giannelli, Ilaria; Tamburrelli, Francesco Ciro; Leone, Alessandro

doi:10.1007/s11547-020-01252-5

Cited by 31 publications

(27 citation statements)

References 30 publications

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“…According to the interbody fusion criteria introduced by Proietti et al [ 6 ] and Berjano et al [ 7 ], the interbody fusion was obtained when one or more bony bridges were present in the intervertebral space confirmed by 3D-CT in this study. The pseudarthrosis was identified when the bone bridge was absent, no bone graft was visible in the cage, and radiolucency was seen at interfaces, or bone resorption surrounding the cage or the screws.…”

Section: Methodsmentioning

confidence: 73%

Lumbar degenerative disease treated by percutaneous endoscopic transforaminal lumbar interbody fusion or minimally invasive surgery-transforaminal lumbar interbody fusion: a case-matched comparative study

Xue

Diao

et al. 2021

J Orthop Surg Res

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Purpose This study aimed to evaluate the clinical efficacy and imaging results of percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) through comparing it with minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF). Materials and methods We performed a retrospective analysis on patients with lumbar degenerative disease treated by PETLIF or MISTLIF from September 2017 to January 2019, and the patients were divided into two groups: the PETLIF group and the MISTLIF group. The clinical and imaging parameters of the two groups were evaluated. Results There was no significant difference between the two groups in operative time and complication rate. The estimated blood loss and the length of hospital stay in the PETLIF group were significantly better than those in the MISTLIF group. Compared with those before operation, the postoperative VAS-L and VAS-B scores were significantly improved after operation in the both groups. In addition, the postoperative VAS-B score of the PETLIF group was significantly lower than that of the MISTLIF group. At the last follow-up, there was no significant difference between the two groups in the VAS-L score, VAS-B score, ODI score, and bony fusion rate. Conclusions Both PETLIF and MISTLIF could achieve satisfactory clinical outcomes in the treatment of lumbar degenerative disease, but our study suggested that PETLIF had less damage, rapid recovery after operation, and short discharge time.

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Section: Methodsmentioning

confidence: 73%

Lumbar degenerative disease treated by percutaneous endoscopic transforaminal lumbar interbody fusion or minimally invasive surgery-transforaminal lumbar interbody fusion: a case-matched comparative study

Xue

Diao

et al. 2021

J Orthop Surg Res

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“…Additionally, wedging angle and its difference between time points at OLIF levels were determined. Fusion at 1 year postoperatively was confirmed interbody bone bridges inside or around the cage evaluated by multiplanar CT [ 18 ]. All radiographs were assessed by two independent examiners (spine surgeons), blinded to conditions, and not associated with the surgical procedure.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and location of endplate fracture and subsidence after oblique lumbar interbody fusion for adult spinal deformity

Inoue

Saito

Miyagi

et al. 2021

BMC Musculoskelet Disord

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Background Recently, Oblique lumbar interbody fusion (OLIF) is commonly indicated to correct the sagittal and coronal alignment in adult spinal deformity (ASD). Endplate fracture during surgery is a major complication of OLIF, but the detailed location of fracture in vertebral endplate in ASD has not yet been determined. We sought to determine the incidence and location of endplate fracture and subsidence of the OLIF cage in ASD surgery, and its association with fusion status and alignment. Methods We analyzed 75 levels in 27 patients were analyzed using multiplanar CT to detect the endplate fracture immediately after surgery and subsidence at 1 year postoperatively. The prevalence was compared between anterior and posterior, approach and non-approach sides, and concave and convex side. Their association with fusion status, local and global alignment, and complication was also investigated. Results Endplate fracture was observed in 64 levels (85.3%) in all 27 patients, and the incidence was significantly higher in the posterior area compared with the anterior area (85.3 vs. 68.0%, p=0.02) of affected vertebra in the sagittal plane. In the coronal plane, there was no significant difference in incidence between left (approach) and right (non-approach) sides (77.3 and 81.3%, respectively), or concave and convex sides (69.4 and 79.6%) of wedged vertebra. By contrast, cage subsidence at 1 year postoperatively was noted in 14/75 levels (18.7%), but was not associated with endplate fracture. Fusion status, local and global alignment, and complications were not associated with endplate fracture or subsidence. Conclusion Endplate fracture during OLIF procedure in ASD cases is barely avoidable, possibly induced by the corrective maneuver with ideal rod counter and cantilever force, but is less associated with subsequent cage subsidence, fusion status, and sustainment of corrected alignment in long fusion surgery performed even for elderly patients.

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“…Complications and radiological ndings were evaluated. Measurements of slippage, treated intervertebral heights, evaluation of endplate injury during surgery, malposition of the pedicle screws and screw loosening, inserted cage position in the interbody space, bone union based on the Proietti classi cation [4], and cage subsidence (over 2 mm) were included in the radiological investigations. Regarding radiological evaluations, bone union was assessed using computed tomography (CT) 12 months after surgery, and the other factors were evaluated by X-rays at the nal observation.…”

Section: Evaluation Of Clinical Variablesmentioning

confidence: 99%

“…Subsequently, the use of minimally invasive spinal surgery involving LLIF combined with posterior percutaneous pedicle screw (PPS) xation [3] for degenerative lumbar disease was reported. Utilization of a cage with a large footprint in LLIF leads to a high fusion rate [4][5][6] and neurological improvement because of the indirect decompression effect and excellent alignment correction [2,7]. This surgical strategy has been adopted in patients with SL, and good clinical and radiological results have been demonstrated [8][9][10][11][12][13][14][15][16][17].…”

mentioning

confidence: 99%

Lateral lumbar interbody fusion after reduction using the percutaneous pedicle screw system in the lateral position for Meyerding grade II spondylolisthesis: a preliminary report of a new lumbar reconstruction strategy

Takami

Taiji

Okada

et al. 2020

Preprint

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Background: Utilization of a cage with a large footprint in lateral lumbar interbody fusion (LLIF) for the treatment of spondylolisthesis leads to a high fusion rate and neurological improvement owing to the indirect decompression effect and excellent alignment correction. However, if an interbody space is too narrow for insertion of an LLIF cage for cases of spondylolisthesis of Meyerding grade II or higher, LLIF cannot be used. Therefore, we developed a novel strategy, LLIF after reduction by the percutaneous pedicle screw (PPS) insertion system in the lateral position (LIFARL), for surgeons to perform accurate and safe LLIF with PPS in patients with such pathology. This study aimed to introduce the new surgical strategy and to present preliminary clinical and radiological results of patients with spondylolisthesis of Meyerding grade II.Methods: Six consecutive patients (four men and two women; mean age, 72.7 years-old; mean follow-up period, 15.3 months) with L4 spondylolisthesis of Meyerding grade II were included. Regarding the surgical procedure, first, PPSs were inserted into the L4 and L5 vertebrae fluoroscopically, and both rods were placed in the lateral position. The L5 set screws were fixed tightly, and the L4 side of the rod was floated. Second, the L4 vertebra was reduced by fastening the L4 set screws so that they expanded the anteroposterior width of the interbody space. At that time, the L4 set screws were not fully tightened to the rods to prevent the endplate injury. Finally, the LLIF procedure was started. After inserting the cage, a compression force was added to the PPSs, and the L4 set screws were completely fastened. Results: The mean operative time was 183 min, and the mean blood loss was 90.8 mL. All cages were positioned properly. Visual analog scale score and Oswestry disability index improved postoperatively. Bone union was observed using computed tomography 12 months after surgery.Conclusion: For cases with difficulty in LLIF cage insertion for Meyerding grade II spondylolisthesis due to the narrow anteroposterior width of interbody space, LIFARL is an option to achieve LLIF combined with posterior PPS accurately and safely.Trial registration: UMIN-Clinical Trials Registry, UMIN000040268, Registered 29 April 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000045938

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Radiological evaluation of fusion patterns after lateral lumbar interbody fusion: institutional case series

Cited by 31 publications

References 30 publications

Lumbar degenerative disease treated by percutaneous endoscopic transforaminal lumbar interbody fusion or minimally invasive surgery-transforaminal lumbar interbody fusion: a case-matched comparative study

Lumbar degenerative disease treated by percutaneous endoscopic transforaminal lumbar interbody fusion or minimally invasive surgery-transforaminal lumbar interbody fusion: a case-matched comparative study

Prevalence and location of endplate fracture and subsidence after oblique lumbar interbody fusion for adult spinal deformity

Lateral lumbar interbody fusion after reduction using the percutaneous pedicle screw system in the lateral position for Meyerding grade II spondylolisthesis: a preliminary report of a new lumbar reconstruction strategy

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