Reduction in foraminal height after lateral access surgery does not affect quality of life: A 2-year outcome study on lateral lumbar interbody fusion

Aim: To compare the screw accuracy and clinical outcomes between robot-assisted minimally invasive transforaminal lumbar interbody fusion (RA MIS-TLIF) and open TLIF in the treatment of one-level lumbar degenerative disease. Materials & methods: From May 2018 to December 2019, a consecutive series of patients undergoing robot-assisted minimally invasive one-level lumbar fusion procedures were retrospectively compared with matched controls who underwent one-level open TLIF procedures for clinical and quality-of-life outcomes. Results: A total of 52 patients underwent RA MIS-TLIF procedures (robot-assisted [RA] group) and 52 matched controls received freehand open TLIF procedures (open [OP] group). The RA group had more grade A screws with 96.2% one-time success rate of screw placement (p < 0.05). Besides, the RA group experienced less intraoperative blood loss and shorter length of hospital stay, while the OP group had shorter operative duration and cumulative radiation time (p < 0.001). What is more, the average VAS score for low back pain and ODI score in the RA group were lower than that in the OP group 1 month after operation (p < 0.05). Conclusion: The use of real-time, image-guided robot system may further expand the advantages of MIS-TLIF technique in terms of accuracy and safety.

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Simple Prediction of Reasonable Lumbar Lordosis Based on Patient's Postoperative Quality of Life Score

10.21203/rs.3.rs-285064/v1 ◽

2021 ◽

Author(s):

Chunlei Wang ◽

Xianzhong Meng ◽

Jiangnan Wu ◽

Hengrui Chang ◽

Chang Liu

Keyword(s):

Quality Of Life ◽

Regression Analysis ◽

Lumbar Lordosis ◽

Interbody Fusion ◽

Posterior Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Lumbar Surgery ◽

Good Hrqol

Abstract Background: Scarce information exists on the relationship between lumbar lordosis (LL) and health-related quality of life (HRQOL) after lumbar surgery. The aim of this study was to derive a predictive equation for lordosis using pelvic incidence and to establish a simple lumbar lordosis prediction method to improve the quality of life after surgery.Methods: A number of 146 patients with lumbar surgery were included in the study. Spinopelvic parameters and Oswestry Disability Index (ODI) were measured at the final follow-up. At the 75th percentile cut-off value, patients with ODI were assigned to a good HRQOL group. Stepwise multiple regression analysis was used to analyze the correlation between parameters and ODI, and simple linear regression analysis was conducted to deduce the predictive equation for the recovery of reasonable LL by posterior lumbar interbody fusion (PLIF).Results: In the good HRQOL group, we included 108 patients with an ODI score less than 29 (75% cut-off value) at the last follow-up. All patients had had completed their posterior lumbar interbody fusion (L4-S1) by the same experienced surgeon. Multiple regression analysis revealed that LL (P < 0.001) was significantly associated with ODI as radiological parameters. The close relationship between PI and LL is highly evident from the value of the regression coefficient (r = 0.765, P < 0.001). Based on the correlation established between the above parameters, the following prediction equation for PI and LL was derived: LL = 0.59 × PI + 12 (r = 0.765, P < 0.001). Conclusions: This simple calculation method can provide a more effective and simple prediction of lumbar lordosis in the Chinese population. This approach can be used as a decision-making tool for restoring LL in lumbar correction surgery and plays an important role in improving the quality of life of patients after lumbar surgery.

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Lateral Lumbar Interbody Fusion (LLIF): An Update

Global Spine Journal ◽

10.1177/2192568220910707 ◽

2020 ◽

Vol 10 (2_suppl) ◽

pp. 17S-21S

Author(s):

Oded Rabau ◽

Rodrigo Navarro-Ramirez ◽

Mina Aziz ◽

Alisson Teles ◽

Susan Mengxiao Ge ◽

...

Keyword(s):

Lumbar Spine ◽

Interbody Fusion ◽

Treatment Modalities ◽

Lumbar Interbody Fusion ◽

Degenerative Lumbar Spine ◽

Lateral Lumbar Interbody Fusion ◽

Heterogenous Group ◽

Indirect Decompression ◽

Spine Disease

Degenerative lumbar spine disease (DLSD) is a heterogenous group of conditions that can significantly affect patients’ quality of life. Lateral lumbar interbody fusion (LLIF) is one of the treatment modalities for DLSD that has been increasing in popularity over the past decade. The treatment of DLSD should be individualized based on patients’ symptoms and characteristics to maximize outcomes. Methods: Literature review, invited review. Results: In this article, we will (1) review the use of the LLIF technique in the treatment of degenerative lumbar spine disease, (2) review the current concepts of LLIF, and (3) explore the evidence to date that will allow the reader to maximize the benefits of this technique. Conclusions: LLIF is an alternative for the treatment of degenerative pathologies of the lumbar spine via indirect decompression.

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Reliability and quality of online patient education videos for lateral lumbar interbody fusion

Journal of Neurosurgery Spine ◽

10.3171/2020.4.spine191539 ◽

2020 ◽

Vol 33 (5) ◽

pp. 652-657

Author(s):

Michael D. White ◽

Kristy Latour ◽

Martina Giordano ◽

Tavis Taylor ◽

Nitin Agarwal

Keyword(s):

Patient Education ◽

Interbody Fusion ◽

Medical Knowledge ◽

Average Score ◽

Lumbar Interbody Fusion ◽

Lateral Lumbar Interbody Fusion ◽

Search Terms ◽

Increasing Trend ◽

Online Patient Education

OBJECTIVEThere is an increasing trend among patients and their families to seek medical knowledge on the internet. Patients undergoing surgical interventions, including lateral lumbar interbody fusion (LLIF), often rely on online videos as a first source of knowledge to familiarize themselves with the procedure. In this study the authors sought to investigate the reliability and quality of LLIF-related online videos.METHODSIn December 2018, the authors searched the YouTube platform using 3 search terms: lateral lumbar interbody fusion, LLIF surgery, and LLIF. The relevance-based ranking search option was used, and results from the first 3 pages were investigated. Only videos from universities, hospitals, and academic associations were included for final evaluation. By means of the DISCERN instrument, a validated measure of reliability and quality for online patient education resources, 3 authors of the present study independently evaluated the quality of information.RESULTSIn total, 296 videos were identified by using the 3 search terms. Ten videos met inclusion criteria and were further evaluated. The average (± SD) DISCERN video quality assessment score for these 10 videos was 3.42 ± 0.16. Two videos (20%) had an average score above 4, corresponding to a high-quality source of information. Of the remaining 8 videos, 6 (60%) scored moderately, in the range of 3–4, indicating that the publication is reliable but important information is missing. The final 2 videos (20%) had a low average score (2 or below), indicating that they are unlikely to be of any benefit and should not be used. Videos with intraoperative clips were significantly more popular, as indicated by the numbers of likes and views (p = 0.01). There was no correlation between video popularity and DISCERN score (p = 0.104). In August 2019, the total number of views for the 10 videos in the final analysis was 537,785.CONCLUSIONSThe findings of this study demonstrate that patients who seek to access information about LLIF by using the YouTube platform will be presented with an overall moderate quality of educational content on this procedure. Moreover, compared with videos that provide patient information on treatments used in other medical fields, videos providing information on LLIF surgery are still exiguous. In view of the increasing trend to seek medical knowledge on the YouTube platform, and in order to support and optimize patient education on LLIF surgery, the authors encourage academic neurosurgery institutions in the United States and worldwide to implement the release of reliable video educational content.

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Quality-of-Life Outcomes With Minimally Invasive Transforaminal Lumbar Interbody Fusion Based on Long-Term Analysis of 304 Consecutive Patients

Spine ◽

10.1097/brs.0000000000000078 ◽

2014 ◽

Vol 39 (3) ◽

pp. E191-E198 ◽

Cited By ~ 23

Author(s):

Mick J. Perez-Cruet ◽

Namath S. Hussain ◽

G. Zachary White ◽

Evan M. Begun ◽

Robert A. Collins ◽

...

Keyword(s):

Quality Of Life ◽

Minimally Invasive ◽

Interbody Fusion ◽

Transforaminal Lumbar Interbody Fusion ◽

Lumbar Interbody Fusion ◽

Life Outcomes ◽

Quality Of Life Outcomes ◽

Term Analysis

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Cost-effectiveness of minimally invasive midline lumbar interbody fusion versus traditional open transforaminal lumbar interbody fusion

Journal of Neurosurgery Spine ◽

10.3171/2019.6.spine1965 ◽

2020 ◽

Vol 32 (1) ◽

pp. 31-35

Author(s):

Mladen Djurasovic ◽

Jeffrey L. Gum ◽

Charles H. Crawford ◽

Kirk Owens ◽

Morgan Brown ◽

...

Keyword(s):

Cost Effectiveness ◽

Minimally Invasive ◽

Interbody Fusion ◽

Smoking Status ◽

Transforaminal Lumbar Interbody Fusion ◽

Direct Costs ◽

Lumbar Interbody Fusion ◽

Related Quality ◽

Health Related

OBJECTIVEThe midline transforaminal lumbar interbody fusion (MIDLIF) using cortical screw fixation is a novel, minimally invasive procedure that may offer enhanced recovery over traditional open transforaminal lumbar interbody fusion (TLIF). Little information is available regarding the comparative cost-effectiveness of the MIDLIF over conventional TLIF. The purpose of this study was to compare cost-effectiveness of minimally invasive MIDLIF with open TLIF.METHODSFrom a prospective, multisurgeon, surgical database, a consecutive series of patients undergoing 1- or 2-level MIDLIF for degenerative lumbar conditions was identified and propensity matched to patients undergoing TLIF based on age, sex, smoking status, BMI, diagnosis, American Society of Anesthesiologists Physical Status Classification System (ASA) class, and levels fused. Direct costs at 1 year were collected, including costs associated with the index surgical visit as well as costs associated with readmission. Improvement in health-related quality of life was measured using EQ-5D and SF-6D.RESULTSOf 214 and 181 patients undergoing MIDLIF and TLIF, respectively, 33 cases in each cohort were successfully propensity matched. Consistent with propensity matching, there was no difference in age, sex, BMI, diagnosis, ASA class, smoking status, or levels fused. Spondylolisthesis was the most common indication for surgery in both cohorts. Variable direct costs at 1 year were $2493 lower in the MIDLIF group than in the open TLIF group (mean $15,867 vs $17,612, p = 0.073). There was no difference in implant (p = 0.193) or biologics (p = 0.145) cost, but blood utilization (p = 0.015), operating room supplies (p < 0.001), hospital room and board (p < 0.001), pharmacy (p = 0.010), laboratory (p = 0.004), and physical therapy (p = 0.009) costs were all significantly lower in the MIDLIF group. Additionally, the mean length of stay was decreased for MIDLIF as well (3.21 vs 4.02 days, p = 0.05). The EQ-5D gain at 1 year was 0.156 for MIDLIF and 0.141 for open TLIF (p = 0.821). The SF-6D gain at 1 year was 0.071 for MIDLIF and 0.057 for open TLIF (p = 0.551).CONCLUSIONSCompared with patients undergoing traditional open TLIF, those undergoing MIDLIF have similar 1-year gains in health-related quality of life, with total direct costs that are $2493 lower. Although the findings were not statistically significant, minimally invasive MIDLIF showed improved cost-effectiveness at 1 year compared with open TLIF.

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