Re: Trans-cranial motor evoked potential detection of femoral nerve injury in trans-psoas lateral lumbar interbody fusion

2015 ◽  
Vol 30 (5) ◽  
pp. 743-744
Author(s):  
Justin W. Silverstein
Keyword(s):  
Nerve Injury ◽  
Evoked Potential ◽  
Interbody Fusion ◽  
Femoral Nerve ◽  
Motor Evoked Potential ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Femoral Nerve Injury ◽  
In Trans

Femoral Nerve Neuromonitoring for Lateral Lumbar Interbody Fusion Surgery

2021 ◽  
Author(s):  
Justin W. Silverstein ◽  
Jon Block ◽  
Michael L. Smith ◽  
David A. Bomback ◽  
Scott Sanderson ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Femoral Nerve ◽  
Lumbar Interbody Fusion ◽  
Fusion Surgery ◽  
Lateral Lumbar Interbody Fusion

scholarly journals Saphenous Nerve Somatosensory-Evoked Potentials Monitoring During Lateral Interbody Fusion

2020 ◽  
pp. 219256822092297
Author(s):  
Nick Jain ◽  
Ram Alluri ◽  
Kevin Phan ◽  
Daniel Yanni ◽  
Andrew Alvarez ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Nerve Injury ◽  
Somatosensory Evoked Potentials ◽  
Interbody Fusion ◽  
Femoral Nerve ◽  
Saphenous Nerve ◽  
Lumbar Plexus ◽  
Tubular Retractor ◽  
Femoral Nerve Injury ◽  
Lateral Interbody

Study Design.: Retrospective cohort study. Objectives: To clinically evaluate saphenous nerve somatosensory-evoked potentials (SSEPs) as a reliable and predictable way to detect upper lumbar plexus injury intraoperatively during lateral lumbar trans-psoas interbody fusion (LLIF). Methods: Saphenous nerve SSEPs were obtained by stimulation of inferior medial thigh with needle electrodes and recording from transcranial potentials. The primary outcome was measured by testing reproducibility of SSEPs at baseline, changes during the procedure, and relevance to standard modalities. Significant SSEP changes were compared with actual postoperative nerve complications. The sensitivity and specificity of saphenous SSEPs to detect postoperative lumbar plexus nerve injury was calculated. Results: A total of 62 patients were included in the study. Reliable saphenous SSEPs were recorded on the LLIF approach side in 52/62 patients. Persistent saphenous SSEP reduction of amplitude of >50% in 6 cases was observed during expansion of the tubular retractor or during the procedure. Two of 6 patients postoperatively had femoral nerve sensory deficits, and 5 of 6 patients had mild femoral nerve motor weakness, all of which resolved at an average of 12 weeks postoperatively (range 2-24 weeks). One patient had saphenous SSEP changes but demonstrated intraoperative recovery and had no postoperative clinical deficits. Saphenous SSEPs demonstrated 52% to 100% sensitivity and 90% to 100% specificity for detecting postoperative femoral nerve complications. Conclusion: Saphenous SSEPs can be used to detect electrophysiological changes to prevent femoral nerve injury during LLIF. Intraoperative SSEP recovery after amplitude reduction or loss may be a prognostic factor for final clinical outcome.

Nerve injury after lateral lumbar interbody fusion: a review of 919 treated levels with identification of risk factors

2014 ◽  
Vol 14 (5) ◽  
pp. 749-758 ◽  
Author(s):  
Marios G. Lykissas ◽  
Alexander Aichmair ◽  
Alexander P. Hughes ◽  
Andrew A. Sama ◽  
Darren R. Lebl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nerve Injury ◽  
Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion

Lateral lumbar interbody fusion in revision surgery for restenosis after posterior decompression

2020 ◽  
Vol 49 (3) ◽  
pp. E11 ◽  
Author(s):  
Yoshifumi Kudo ◽  
Ichiro Okano ◽  
Tomoaki Toyone ◽  
Akira Matsuoka ◽  
Hiroshi Maruyama ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Decompression Surgery ◽  
Complication Rates ◽  
Lumbar Interbody Fusion ◽  
Posterior Decompression ◽  
Lateral Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Dural Tears

OBJECTIVEThe purpose of this study was to compare the clinical results of revision interbody fusion surgery between lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) with propensity score (PS) adjustments and to investigate the efficacy of indirect decompression with LLIF in previously decompressed segments on the basis of radiological assessment.METHODSA retrospective study of patients who underwent revision surgery for recurrence of neurological symptoms after posterior decompression surgery was performed. Postoperative complications and operative factors were evaluated and compared between LLIF and PLIF/TLIF. Moreover, postoperative improvement in cross-sectional areas (CSAs) in the spinal canal and intervertebral foramen was evaluated in LLIF cases.RESULTSA total of 56 patients (21 and 35 cases of LLIF and PLIF/TLIF, respectively) were included. In the univariate analysis, the LLIF group had significantly more endplate injuries (p = 0.03) and neurological deficits (p = 0.042), whereas the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), surgical site infections (SSIs) (p = 0.02), and estimated blood loss (EBL) (p < 0.001). After PS adjustments, the LLIF group still showed significantly more endplate injuries (p = 0.03), and the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), EBL (p < 0.001), and operating time (p = 0.04). The PLIF/TLIF group showed a trend toward a higher incidence of SSI (p = 0.10). There was no statistically significant difference regarding improvement in the Japanese Orthopaedic Association scores between the 2 surgical procedures (p = 0.77). The CSAs in the spinal canal and foramen were both significantly improved (p < 0.001).CONCLUSIONSLLIF is a safe, effective, and less invasive procedure with acceptable complication rates for revision surgery for previously decompressed segments. Therefore, LLIF can be an alternative to PLIF/TLIF for restenosis after posterior decompression surgery.

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