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

Abstract Background: We determined 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: We retrospectively reviewed 120 lumbar degenerative disease patients who underwent single-level OLIF. We compared 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). Clinical outcomes were evaluated using Oswestry Disability Index (ODI) scores and visual analog scale (VAS) scores for back and leg pain. All patients were followed up for at least 2 years. Results: Thirty-eight patients had postoperative LBP (VAS score for back pain ≥ 3; LBP group); the remaining 82 patients were in the non-LBP group. Age (P = 0.082), gender (P = 0.425), body mass index (P = 0.138), diagnosis (degenerative spondylolisthesis vs. lumbar spinal stenosis; P = 0.529), surgical level (P = 0.651), blood loss (P = 0.889), and operative time (P = 0.731) did not differ between the groups. In both groups, the ODI and VAS scores for back pain and leg pain significantly improved at the final follow-up compared to the preoperative scores (P = 0.003). Except for the VAS score for back pain (P = 0.000), none of the scores significantly differed between the two groups at the final follow-up (P > 0.05). In the non-LBP group, LL, SL, DH, TK, and SS significantly improved, while PT and C7-SVA significantly decreased at the final follow-up as compared to the preoperative values. In both groups, DH significantly improved postoperatively, with no significant between-group difference (P = 0.325). At the final follow-up, LL, PI-LL mismatch, PT, and C7-SVA showed significantly greater improvement in the non-LBP group than in the LBP group (P < 0.05). Multivariate analysis identified PT, PI-LL mismatch, and C7-SVA as significant risk factors for LBP after OLIF. Conclusion: OLIF for single-level lumbar degenerative disease had satisfactory clinical outcomes. PT, PI-LL mismatch, and C7-SVA were significant risk factors for postoperative LBP. Patients with appropriately decreased PT, improved C7-SVA, and PI-LL match experienced less LBP.

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

10.21203/rs.3.rs-18785/v1 ◽

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.

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Does low back pain or leg pain in gluteus medius syndrome contribute to lumbar degenerative disease and hip osteoarthritis and vice versa? A literature review

Journal of Physical Therapy Science ◽

10.1589/jpts.32.173 ◽

2020 ◽

Vol 32 (2) ◽

pp. 173-191

Author(s):

Masahiro Kameda ◽

Hideyuki Tanimae ◽

Akinori Kihara ◽

Fujio Matsumoto

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Literature Review ◽

Hip Osteoarthritis ◽

Gluteus Medius ◽

Degenerative Disease ◽

Leg Pain ◽

Low Back ◽

Lumbar Degenerative Disease

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Laparoscopic anterior lumbar interbody fusion

Neurosurgical FOCUS ◽

10.3171/foc.1999.7.6.11 ◽

1999 ◽

Vol 7 (6) ◽

pp. E10 ◽

Cited By ~ 6

Author(s):

Mark R. McLaughlin ◽

Jonathan Y. Zhang ◽

Brian R. Subach ◽

Regis W. Haid ◽

Gerald E. Rodts

Keyword(s):

Interbody Fusion ◽

Significant Risk ◽

Posterior Lumbar Interbody Fusion ◽

Anterior Lumbar Interbody Fusion ◽

Degenerative Disease ◽

Laparoscopic Technique ◽

Lumbar Interbody Fusion ◽

Lumbar Degenerative Disease ◽

Single Level ◽

Number Of Patients

In recent years, there has been an unprecedented increase in the number of patients undergoing treatment with interbody fusion devices for degenerative disease of the lumbar spine. These devices can be placed either anteriorly or posteriorly. With the advent of minimally invasive surgery and the increasing ability of general surgeons to perform transperitoneal procedures laparoscopically, a new laparoscopic technique has been developed for placing lumbar interbody fusion devices. Although this procedure has some advantages over posterior lumbar interbody fusion, it is not without significant risk, and the learning curve is steep. The authors review a series of 32 consecutive patients who underwent single-level laparoscopic anterior lumbar interbody fusion at L4–5 or L5–S1 over a 2-year period for the treatment of single-level lumbar degenerative disease. In this report they review the technical aspects of the procedure and the important lessons they have learned through their early experience with this technique.

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Long-term Follow-up (Minimum 5 Years) Study of Single-level Posterior Dynamic Stabilization in Lumbar Degenerative Disease; 'Interspinous U' & 'DIAM'

Korean Journal of Spine ◽

10.14245/kjs.2012.9.2.102 ◽

2012 ◽

Vol 9 (2) ◽

pp. 102 ◽

Cited By ~ 4

Author(s):

Yeon Joon Kim ◽

Sang Gu Lee ◽

Chan Woo Park ◽

Seong Son ◽

Woo Kyung Kim

Keyword(s):

Dynamic Stabilization ◽

Degenerative Disease ◽

Lumbar Degenerative Disease ◽

Single Level ◽

Long Term Follow Up ◽

Posterior Dynamic Stabilization

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

10.21203/rs.3.rs-227251/v1 ◽

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.

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Minimally Invasive Transforaminal Lumbar Interbody Fusion: An Attractive Option for Select Failed Backs

Asian Spine Journal ◽

10.4184/asj.2018.12.1.52 ◽

2018 ◽

Vol 12 (1) ◽

pp. 52-58 ◽

Cited By ~ 3

Author(s):

Arvind G. Kulkarni ◽

Shashidhar Bangalore Kantharajanna ◽

Abhilash N. Dhruv

Keyword(s):

Back Pain ◽

Blood Loss ◽

Interbody Fusion ◽

Transforaminal Lumbar Interbody Fusion ◽

Percentage Change ◽

Leg Pain ◽

Lumbar Interbody Fusion ◽

Vas Scores ◽

The Mean

<sec><title>Study Design</title>Retrospective case series.</sec><sec><title>Purpose</title>To compare minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) outcomes in primary and revision surgeries.</sec><sec><title>Overview of Literature</title>Revision spinal fusion is often associated with an increased risk of approach-related complications. Patients can potentially benefit from the decreased approach-related morbidity associated with MI-TLIF.</sec><sec><title>Methods</title>Sixty consecutive MI-TLIF patients (20 failed back [Fa group], 40 primary [Pr group]) who underwent surgery between January 2011 and May 2012 were reviewed after Institutional Review Board approval to compare operative times, blood loss, complications, Oswestry Disability Index (ODI) scores, and Visual Analog Scale (VAS) scores for back and leg pain before surgery and at the last follow-up.</sec><sec><title>Results</title>Nineteen revision surgeries were compared with 36 primary surgeries. One failed back and four primary patients were excluded because of inadequate data. The mean follow-up times were 28 months and 24 months in the Pr and Fa groups, respectively. The mean pre- and postoperative ODI scores were 53.18 and 20.23 in the Pr group and 52.01 and 25.72 in the Fa group, respectively (ODI percentage change: Pr group, 60.36%±29.73%; Fa group, 69.32%±13.72%; <italic>p</italic>=0.304, not significant). The mean pre- and postoperative VAS scores for back pain were 4.77 and 1.75 in the Pr group and 4.1 and 2.0 in the Fa group, respectively, and the percentage changes were statistically significant (VAS back pain percentage change: Pr group, 48.78±30.91; Fa group, 69.32±13.72; <italic>p</italic>=0.027). The mean pre- and postoperative VAS scores for leg pain were 6.52 and 1.27 in the Pr group and 9.5 and 1.375 in the Fa group, respectively (VAS leg pain percentage change: Pr group, 81.07±29.39; Fa group, 75.72±15.26; <italic>p</italic>=0.538, not significant). There were no statistically significant differences in operative time and estimated blood loss and no complications.</sec><sec><title>Conclusions</title>MI-TLIF outcomes were comparable between primary and revision surgeries. The inherent technique of MI-TLIF is particularly suitable for select failed backs because it exploits the intact paramedian corridor.</sec>

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Correlation of preoperative depression and somatic perception scales with postoperative disability and quality of life after lumbar discectomy

Journal of Neurosurgery Spine ◽

10.3171/2010.10.spine10190 ◽

2011 ◽

Vol 14 (2) ◽

pp. 261-267 ◽

Cited By ~ 87

Author(s):

Kaisorn L. Chaichana ◽

Debraj Mukherjee ◽

Owoicho Adogwa ◽

Joseph S. Cheng ◽

Matthew J. McGirt

Keyword(s):

Quality Of Life ◽

Back Pain ◽

Oswestry Disability Index ◽

Lumbar Discectomy ◽

Leg Pain ◽

Somatic Anxiety ◽

Single Level ◽

Sf 36

Object Lumbar discectomy is the most common surgical procedure performed in the US for patients experiencing back and leg pain from herniated lumbar discs. However, not all patients will benefit from lumbar discectomy. Patients with certain psychological predispositions may be especially vulnerable to poor clinical outcomes. The goal of this study was therefore to determine the role that preoperative depression and somatic anxiety have on long-term back and leg pain, disability, and quality of life (QOL) for patients undergoing single-level lumbar discectomy. Methods In 67 adults undergoing discectomy for a single-level herniated lumbar disc, the authors determined quantitative measurements of leg and back pain (visual analog scale [VAS]), quality of life (36-Item Short Form Health Survey [SF-36]), and disease-specific disability (Oswestry Disability Index) preoperatively and at 6 weeks, 3, 6, and 12 months after surgery. The degree of preoperative depression and somatization was assessed using the Zung Self-Rating Depression Scale and a modified somatic perception questionnaire (MSPQ). Multivariate regression analyses were performed to assess associations between Zung Scale and MSPQ scores with achievement of a minimum clinical important difference (MCID) in each outcome measure by 12 months postoperatively. Results All patients completed 12 months of follow-up. Overall, a significant improvement in VAS leg pain, VAS back pain, Oswestry Disability Index, and SF-36 Physical Component Summary scores was observed by 6 weeks after surgery. Improvements in all outcomes were maintained throughout the 12-month follow-up period. Increasing preoperative depression (measured using the Zung Scale) was associated with a decreased likelihood of achieving an MCID in disability (p = 0.006) and QOL (p = 0.04) but was not associated with VAS leg pain (p = 0.96) or back pain (p = 0.85) by 12 months. Increasing preoperative somatic anxiety (measured using the MSPQ) was associated with decreased likelihood of achieving an MCID in disability (p = 0.002) and QOL (p = 0.03) but was not associated with leg pain (p = 0.64) or back pain (p = 0.77) by 12 months. Conclusions The Zung Scale and MSPQ are valuable tools for stratifying risk in patients who may not experience clinically relevant improvement in disability and QOL after discectomy. Efforts to address these confounding and underlying contributors of depression and heightened somatic anxiety may improve overall outcomes after lumbar discectomy.

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

10.21203/rs.3.rs-227251/v2 ◽

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

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Platelet Concentrate In Lumbar Interbody Cage Fusion: A New Era of Modality Of Fusion

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6130 ◽

2021 ◽

Vol 9 (B) ◽

pp. 356-362

Author(s):

Mohamed Mohi EL din ◽

Ahmed Salah Hassan ◽

Tarek Ahmed Tareef ◽

Mohammad Baraka ◽

Mohamed Gabr ◽

...

Keyword(s):

Back Pain ◽

Leg Pain ◽

Control Group ◽

Time Saving ◽

New Era ◽

Local Bone ◽

Vas Scores ◽

Double Blinded ◽

Cage Migration

AIM: This was a prospective double-blinded randomized comparative study. Several authors have reported the efficacy of platelets derivatives for spinal union. However, the use of PRP and PRF for bone fusion with TLIF has not been fully explored. METHODS: Standard open TLIF surgery was performed on 80 patients, randomized in three groups, TLIF and local bone were used in 40 patients (control group) and TLIF, local bone, and PRP were used in 20 patients (PRP group) and PRF was used in 20 patients (PRF group). Radiological parameters were assessed by X-ray after 3 months post-operative to evaluate the position of the screws and cage migration and by CT scans at 6 months and 12 months postoperatively. Patients, surgeons, and post-surgical analysis were blinded. RESULTS: VAS scores for lower back pain and leg pain were statistically significant between the three groups preoperatively. The VAS scores of back pain improved after 12 months and were statistically significant (p < 0.001) and the VAS score of leg pain improved compared with preoperatively in the three groups during the 6- and 12-month follow-up postoperatively, however, the three groups, VAS scores for leg pain were not significantly different. After 1-year follow-up, significantly more patients achieved definite fusion, when implanted platelets derivatives compared with the control group, but with no significance regarding fusion rates. CONCLUSION: We advocated using platelet derivative as a fusion enhancer modality which is cost and time saving. It appears to be a complementary step that ensures better outcome for the patients.

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