Clinical Outcomes of Lateral Lumbar Interbody Fusion Combined with Percutaneous Endoscopic Lumbar Discectomy During the Treatment of Low-grade Spondylolisthesis

2020 ◽  
Author(s):  
Jiaqi Li ◽  
Yapeng Sun ◽  
Wei Zhang ◽  
Fei Zhang ◽  
Lei Guo ◽  
...  

Abstract Background Minimally invasive lateral lumbar interbody fusion (LLIF) in combination with percutaneous endoscopic lumbar discectomy (PELD) can achieve interbody fusion and direct decompression, but their combined use has not been widely reported. In this study, the clinical outcomes of LLIF in combination with PELD in low-grade spondylolisthesis was evaluated, particularly in cases of a requirement for direct decompression. Methods Patients with single-level low-grade spondylolisthesis, undergoing LLIF in combination with PELD were included. The severity of lower back and leg pain was reported using visual analog scale (VAS). The Oswestry disability index (ODI) was used to evaluate functional improvements of patients. A comparison of preoperative and postoperative indicators was performed through repeated measures of analysis of variance. P < 0.05 was considered as a statistically significant difference. Results A total of 48 patients (20 males and 28 females) were included. The intraoperative blood loss was 112.60ml ± 43.69 and the average operation time was 116.35min ± 22.31. VAS and ODI were significantly improved in all stages after operation. The fusion rate at the final follow-up was 93.7%. No injuries occurred to the vessels, nerves and organs during the perioperative period. Conclusions LLIF in combination with PELD achieved adequate decompression and intervertebral fusion, with precise and reliable clinical outcomes. In addition, the procedure was minimally invasive, resulting in small tissue injury and rapid postoperative recovery. Multi-center prospective comparative studies are now needed to further confirm the superiority of this combination.

2015 ◽  
Vol 22 (4) ◽  
pp. 740-746 ◽  
Author(s):  
Amir Ahmadian ◽  
Konrad Bach ◽  
Bryan Bolinger ◽  
Gregory M. Malham ◽  
David O. Okonkwo ◽  
...  

Neurosurgery ◽  
2020 ◽  
Author(s):  
Song Kim ◽  
Alp Ozpinar ◽  
Nitin Agarwal ◽  
Emily Hacker ◽  
Nima Alan ◽  
...  

Abstract BACKGROUND Opioid use in the management of pain secondary to spinal disorders has grown significantly in the United States. However, preoperative opioid use may complicate recovery in patients undergoing surgical procedures. OBJECTIVE To test our hypothesis that prolonged preoperative opioid use may lead to poorer patient outcomes following minimally invasive stand-alone lateral lumbar interbody fusion (LLIF) for lumbar degenerative disc disease. METHODS A consecutive series of patients from a single institution undergoing LLIF between December 2009 and January 2017 was retrospectively analyzed. Patients were categorized according to the presence or absence of prescribed preoperative opioid use for at least 3 mo. Outcomes included the Oswestry Disability Index (ODI), visual analog scale (VAS), and Short Form 36 Physical and Mental Summary Scores (SF-36 PCS, SF-36 MCS). RESULTS Of 107 patients, 57 (53.1%) were prescribed preoperative opioids. There was no significant difference in preoperative ODI, VAS score, SF-36 PCS, or SF-36 MCS between opioid use groups. Mean postoperative ODI was greater in patients with preoperative opioid use at 41.7 ± 16.9 vs 22.2 ± 16.0 (P = .002). Mean postoperative VAS score was greater in patients prescribed preoperative opioids, while magnitude of decrease in VAS score was greater in opioid-naïve patients (P = .001). Postoperative SF-36 PCS was 33.1 ± 10.6 in the opioid use group compared to 43.7 ± 13.1 in the nonuse group (P = .001). CONCLUSION Following LLIF, patients prescribed preoperative opioids had increased postoperative lumbar pain, disability, and subjective pain.


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