scholarly journals Lumbar degenerative disease after oblique lateral interbody fusion: sagittal spinopelvic alignment and its impact on low back pain

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jia Li ◽  
Di Zhang ◽  
Yong Shen ◽  
Xiangbei Qi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Degenerative Disease ◽  
Low Back ◽  
Lumbar Degenerative Disease ◽  
Lateral Interbody Fusion ◽  
Spinopelvic Alignment ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

scholarly journals Comparison of clinical outcomes achieved with oblique lateral interbody fusion with or without supplementary instrumentation in patients with single-level lumbar degenerative disease

2021 ◽  
Author(s):  
Zhao Lang ◽  
Yuqing Sun ◽  
Qiang Yuan ◽  
Jingye Wu ◽  
Mingxing Fan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Disease ◽  
Mineral Density ◽  
Lumbar Degenerative Disease ◽  
Single Level ◽  
Lateral Interbody Fusion ◽  
Estimated Blood Loss ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Abstract Background Oblique lateral interbody fusion (OLIF) is applied often to treat degenerative disc disease in the lumbar spine. Stand-alone OLIF prevents morbidities associated with supplemental fixation and is less expensive. However, it remains controversial whether stand-alone OLIF is sufficient to avoid subsidence for single-level diseases. Additionally, bilateral pedicle screw (BPS) and bilateral transfacet screw (BTS) fixation are well-established posterior fixation methods that can offer improved biomechanical stability. But the comparison of clinical outcomes of OLIF with and without supplementary instrumentation is lack. Methods We retrospectively examined 20 patients who underwent single-level stand-alone OLIF for symptomatic lumbar degenerative disease at L1–L5 (SA group). Groups of patients treated with OLIF plus BPS (n = 20, BPS group) or BTS (n = 20, BTS group) were matched for age, sex, diagnosis, operative level, body mass index, and bone mineral density. The disk height index (DHI), segmental lordotic (SL) angle, and lumbar lordotic (LL) angle were measured preoperatively and at 3 days and 6 months postoperatively. Clinical outcomes were evaluated. Results Significant disc height loss was observed in all groups, but was greater in the SA and BTS groups than in the BPS group at the 6-month follow-up. The SL and LL angles were not affected in any group. The operative time was significantly less in the SA group, and the estimated blood loss was significantly higher in the BPS group. At 6 months post-surgery, improvements in clinical outcomes were evident in all groups, but the VAS (back pain), JOA, and ODI scores were worse in the SA group than in the other groups. Conclusions Stand-alone OLIF was associated with greater subsidence and poorer clinical outcomes compared with OLIF plus supplementary instrumentation. The addition of BTS did not decrease the degree of subsidence, but provided clinical outcomes comparable to those achieved with BPS.

scholarly journals Lumbar degenerative disease after oblique lateral interbody fusion: sagittal spinopelvic alignment and its impact on low back pain

2020 ◽  
Author(s):  
Jia Li ◽  
Di Zhang ◽  
Yong Shen ◽  
Xiangbei Qi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Degenerative Disease ◽  
Leg Pain ◽  
Low Back ◽  
Lumbar Degenerative Disease ◽  
Single Level ◽  
Vas Scores ◽  
Oblique Lateral Interbody Fusion

Abstract Background: The objective of the retrospective study was to investigated the incidence and risk factors of low back pain (LBP) in patients with lumbar degenerative disease after single-level oblique lateral interbody fusion(OLIF).Methods: In this retrospective study, 120 patients who undergoing single-level OLIF to treat lumbar degenerative disease were recruited. Preoperative and postoperative radiographic parameters, including segmental lordosis(SL), lumbar lordosis(LL), disk height(DH), pelvic incidence(PI), pelvic tilt (PT), sacral slope(SS), thoracic kyphosis(TK), C7-sagittal vertical axis (SVA). Visual analog scale(VAS) for back and leg pain, and Oswestry Disability Index(ODI), were used to evaluate symptoms and quantify disability. All patients achieved at least two-year follow-up.Results: A total of 120 Patients who complained low back pain were apportioned to LBP group (n=38; VAS scores for back pain≥3) or Non-LBP group (n=82;VAS scores for back pain＜3). There was no difference in age(P=0.082), gender(P=0.425), body mass index(P=0.138), degenerative spondylolisthesis or lumbar spinal stenosis(P=0.529) surgical level(P=0.651), blood Loss (P=0.889) and operative time(P=0.731) between the groups. In both groups, the ODI and VAS scores for back pain and leg pain were significantly improved at the final follow-up compared to the preoperative scores (P=0.003). Furthermore, except for the LBP (P=0.000), there were no significant differences in these scores between the two groups at the final follow-up (P > 0.05). According to the radiographic parameters, in Non-LBP group, the LL, SL, DH, TK and SS had all significantly improved; PT and C7-SVA significantly decreased at the final follow-up compared to the preoperative values. The DH in both groups had significantly improved, no significant difference was found(P=0.325). In the final follow-up, LL, PI-LL, PT and C7-SVA in Non-LBP group had more improvements compared to the LBP group (P＜0.05) . Multivariate analysis showed that PT, PI-LL and C7-SVA were identified as significant risk factors for LBP after OLIF.Conclusion: The clinical outcomes of OLIF for single-level lumbar degenerative disease were satisfactory. Our findings showed that PT, PI-LL mismatch and C7-SVA had the greatest impact on the incidence of LBP. Therefore, patients with appropriate decreased PT, improved C7-SVA and PI-LL match experienced less low back pain.

scholarly journals Comparison of clinical outcomes achieved with oblique lateral interbody fusion with or without supplementary instrumentation in patients with single-level lumbar degenerative disease

2021 ◽  
Author(s):  
Zhao Lang ◽  
Yuqing Sun ◽  
Qiang Yuan ◽  
Jingye Wu ◽  
Mingxing Fan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Disease ◽  
Mineral Density ◽  
Lumbar Degenerative Disease ◽  
Single Level ◽  
Lateral Interbody Fusion ◽  
Estimated Blood Loss ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Abstract Background Oblique lateral interbody fusion (OLIF) is applied often to treat degenerative disc disease in the lumbar spine. Stand-alone OLIF prevents morbidities associated with supplemental fixation and is less expensive. However, it remains controversial whether stand-alone OLIF is sufficient to avoid subsidence for single-level diseases. Additionally, bilateral pedicle screw (BPS) and bilateral transfacet screw (BTS) fixation are well-established posterior fixation methods that can offer improved biomechanical stability. But the comparison of clinical outcomes of OLIF with and without supplementary instrumentation is lack. Methods We retrospectively examined 20 patients who underwent single-level stand-alone OLIF for symptomatic lumbar degenerative disease at L1–L5 (SA group). Groups of patients treated with OLIF plus BPS (n = 20, BPS group) or BTS (n = 20, BTS group) were matched for age, sex, diagnosis, operative level, body mass index, and bone mineral density. The disk height index (DHI), segmental lordotic (SL) angle, and lumbar lordotic (LL) angle were measured preoperatively and at 3 days and 6 months postoperatively. Clinical outcomes were evaluated. Results Significant disc height loss was observed in all groups, but was greater in the SA and BTS groups than in the BPS group at the 6-month follow-up. The SL and LL angles were not affected in any group. The operative time was significantly less in the SA group, and the estimated blood loss was significantly higher in the BPS group. At 6 months post-surgery, improvements in clinical outcomes were evident in all groups, but the VAS (back pain), JOA, and ODI scores were worse in the SA group than in the other groups. Conclusions Stand-alone OLIF was associated with greater subsidence and poorer clinical outcomes compared with OLIF plus supplementary instrumentation. The addition of BTS did not decrease the degree of subsidence, but provided clinical outcomes comparable to those achieved with BPS.

scholarly journals Lateral Interbody Fusion for Treatment of Discogenic Low Back Pain: Minimally Invasive Surgical Techniques

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Luis Marchi ◽  
Leonardo Oliveira ◽  
Rodrigo Amaral ◽  
Carlos Castro ◽  
Thiago Coutinho ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Minimally Invasive ◽  
Interbody Fusion ◽  
Surgical Techniques ◽  
Low Back ◽  
Lateral Interbody Fusion ◽  
Discogenic Low Back Pain ◽  
Cage Subsidence ◽  
Lateral Interbody

Low back pain is one of the most common ailments in the general population, which tends to increase in severity along with aging. While few patients have severe enough symptoms or underlying pathology to warrant surgical intervention, in those select cases treatment choices remain controversial and reimbursement is a substancial barrier to surgery. The object of this study was to examine outcomes of discogenic back pain without radiculopathy following minimally-invasive lateral interbody fusion. Twenty-two patients were treated at either one or two levels (28 total) between L2 and 5. Discectomy and interbody fusion were performed using a minimallyinvasive retroperitoneal lateral transpsoas approach. Clinical and radiographic parameters were analyzed at standard pre- and postoperative intervals up to 24 months. Mean surgical duration was 72.1 minutes. Three patients underwent supplemental percutaneous pedicle screw instrumentation. Four (14.3%) stand-alone levels experienced cage subsidence. Pain (VAS) and disability (ODI) improved markedly postoperatively and were maintained through 24 months. Segmental lordosis increased significantly and fusion was achieved in 93% of levels. In this series, isolated axial low back pain arising from degenerative disc disease was treated with minimally-invasive lateral interbody fusion in significant radiographic and clinical improvements, which were maintained through 24 months.

scholarly journals Association between mild cognitive impairment and lumbar degenerative disease in a Japanese community: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258852
Author(s):  
Kazushige Koyama ◽  
Kanichiro Wada ◽  
Gentaro Kumagai ◽  
Hitoshi Kudo ◽  
Sunao Tanaka ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Cognitive Impairment ◽  
Back Pain ◽  
Cross Sectional Study ◽  
Summary Score ◽  
Degenerative Disease ◽  
Low Back ◽  
Sectional Study ◽  
Lumbar Degenerative Disease ◽  
Cross Sectional

Lumbar degenerative disease and dementia are increasing in super-aging societies and are both related to physical dysfunction and pain. However, the relationship between these diseases remains unclear. This cross-sectional study aimed to investigate the comorbidity rates of lumbar spinal canal stenosis (LSS) and mild cognitive impairment (MCI) and clarify the association between LSS presence, lumbar symptoms, and quality of life (QOL) related to low back pain and cognitive impairment in the Japanese population. We enrolled 336 participants (men 124; women 212; mean age 72.2 years) from a medical checkup program. LSS was diagnosed using a self-administered questionnaire, and lumbar symptoms were evaluated using the visual analog scale (low back pain, and pain and numbness of the lower limb). QOL related to low back pain was evaluated using the Japanese Orthopedic Association Back-Pain Evaluation Questionnaire (JOABPEQ: pain, and lumbar, and gait function). Radiological lumbar degeneration was classified using Kellgren-Lawrence grading and lateral radiographs of the lumbar spine. Cognitive function was measured using the Mini Mental State Examination (MMSE), and MCI was defined by a summary score of MMSE ≤27. Logistic and multiple linear regression analyses were performed to analyze the association between MCI, summary score of MMSE, and lumbar degenerative disease. The comorbidity rate of MCI and LSS was 2.1%, and the rate of MCI was 41% in participants with LSS. Lumbar function in JOABPEQ was associated with MCI. The presence of LSS and lumbar function in JOABPEQ were associated with MMSE. Over one-third of the people with LSS had MCI. The presence of LSS and deterioration of QOL due to low back pain were related to cognitive impairment. We recommend evaluating cognitive function for patients with LSS because the rate of MCI was high in LSS participants.

scholarly journals Analysis of Cell-free Circulating DNA Fragment Size and Level in Patients With Lumbar Degenerative Disease

2021 ◽  
Author(s):  
Akihiko Hiyama ◽  
Daisuke Sakai ◽  
Satoshi Nomura ◽  
Hiroyuki Katoh ◽  
Masahiko Watanabe
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Fragment Size ◽  
Degenerative Disease ◽  
Control Group ◽  
Circulating Dna ◽  
Healthy Controls ◽  
Low Back ◽  
Lumbar Degenerative Disease ◽  
Free Circulating Dna

Abstract Background: Cell-free circulating DNA (cfDNA), which can be extracted by liquid biopsy, has been studied as a noninvasive biomarker for various diseases. The potential of cfDNA fragment size and level as a marker for low back pain (LBP) has never been studied. We investigated whether cfDNA is a biomarker of LBP severity in patients with a lumbar degenerative disease (LDD). Methods: Blood samples were obtained from patients with LDD (n = 21) before and immediately after spinal surgery. Plasma DNA was isolated and examined for cfDNA fragment size and concentration. A cohort of healthy volunteers (n = 5) constituted the control group.Results: The cfDNA fragment size tended to be shorter in patients than in healthy controls, but this difference was not significant (P = .224). cfDNA level was significantly higher in LDD patients (mean 0.642±0.199 ng/mL, range 0.302–1.150 ng/mL) than in healthy controls (mean 0.429±0.064 ng/mL, range 0.366–0.506 ng/mL) (P = .029). cfDNA level correlated positively with present pain (r = .421, P = .036), maximum pain (r = .419, P = .037), average pain (r = .566, P = .003), low back pain (r = .403, P = .041), leg pain (r = .480, P = .013), and leg numbness (r = .455, P = .020). cfDNA fragment size did not differ from before to after surgery, but cfDNA level increased postoperatively in patients with LDD. Conclusions: This was the first study investigating whether cfDNA fragment size and level are associated with pain, including LBP, in patients with LDD. Our findings suggest that cfDNA level may be an objective indicator of pain and surgical invasiveness in patients with LDD.

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