Clinical and Radiological Results After Minimally Invasive Transpsoas Lateral Access Surgery for Degenerative Lumbar Stenosis

Clinical and Radiological Results After Minimally Invasive Transpsoas Lateral Access Surgery for Degenerative Lumbar Stenosis

Study Design: Prospective cohort study. Objective: The lateral transpsoas access is a retroperitoneal approach for the lumbar spine to perform the lateral lumbar interbody fusion (LLIF), an intersomatic arthrodesis performed with a cage placed on the lateral borders of the epiphyseal ring. The proce...

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Veröffentlicht in:Global spine journal 2020-08, Vol.10 (5), p.603-610
Hauptverfasser: Coutinho, Thiago Pereira, Cristante, Alexandre Fogaça, Marcon, Raphael Martus, da Rocha, Ivan Dias, Ono, Allan Hiroshi, Meyer, Guilherme Pereira Correa, Barros Filho, Tarcísio Eloy de Pessoa
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Back surgery
Degenerative disc disease
Original
Spine
Surgical techniques
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container_end_page 610
container_issue 5
container_start_page 603
container_title Global spine journal
container_volume 10
creator Coutinho, Thiago Pereira
Cristante, Alexandre Fogaça
Marcon, Raphael Martus
da Rocha, Ivan Dias
Ono, Allan Hiroshi
Meyer, Guilherme Pereira Correa
Barros Filho, Tarcísio Eloy de Pessoa
description Study Design: Prospective cohort study. Objective: The lateral transpsoas access is a retroperitoneal approach for the lumbar spine to perform the lateral lumbar interbody fusion (LLIF), an intersomatic arthrodesis performed with a cage placed on the lateral borders of the epiphyseal ring. The procedure can be used to provide indirect decompression of the nervous structures through the discectomy and restoration of the disc height. The objective of the present study was to evaluate the indirect decompression following LLIF both with radiological and clinical parameters. Methods: Prospective clinical and radiological study in a single center with 20 patients diagnosed with 1- or 2-level degenerative lumbar stenosis. Radiological analysis on magnetic resonance imaging included foramen height, canal area, canal diameter, and disc height. Clinical outcomes included visual analogue scale (VAS) and Oswestry Disability Index (ODI) collected up to 12 months. Complications and reoperations were recorded. Results: In total, 25 levels were treated. No reoperation was required. Disc height was increased by an average of 25% (P < .001). The canal area increased from 109 to 149 mm2 (P < .001) and from 9.3 to 12.2 mm (P < .001) in anteroposterior diameter. The foramen area demonstrated the effect of indirect decompression on both sides (P < .001). The height of the foramen showed significant average increase of 2.8 mm (P < .001). The results from VAS and ODI questionnaires confirmed the clinical effect of indirect decompression. Conclusion: We observed that indirect decompression by the LLIF method is feasible both radiologically and clinically with a low rate of complications and reoperations.
doi_str_mv 10.1177/2192568219865186
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Objective: The lateral transpsoas access is a retroperitoneal approach for the lumbar spine to perform the lateral lumbar interbody fusion (LLIF), an intersomatic arthrodesis performed with a cage placed on the lateral borders of the epiphyseal ring. The procedure can be used to provide indirect decompression of the nervous structures through the discectomy and restoration of the disc height. The objective of the present study was to evaluate the indirect decompression following LLIF both with radiological and clinical parameters. Methods: Prospective clinical and radiological study in a single center with 20 patients diagnosed with 1- or 2-level degenerative lumbar stenosis. Radiological analysis on magnetic resonance imaging included foramen height, canal area, canal diameter, and disc height. Clinical outcomes included visual analogue scale (VAS) and Oswestry Disability Index (ODI) collected up to 12 months. Complications and reoperations were recorded. Results: In total, 25 levels were treated. No reoperation was required. Disc height was increased by an average of 25% (P &lt; .001). The canal area increased from 109 to 149 mm2 (P &lt; .001) and from 9.3 to 12.2 mm (P &lt; .001) in anteroposterior diameter. The foramen area demonstrated the effect of indirect decompression on both sides (P &lt; .001). The height of the foramen showed significant average increase of 2.8 mm (P &lt; .001). The results from VAS and ODI questionnaires confirmed the clinical effect of indirect decompression. Conclusion: We observed that indirect decompression by the LLIF method is feasible both radiologically and clinically with a low rate of complications and reoperations.</description><identifier>ISSN: 2192-5682</identifier><identifier>EISSN: 2192-5690</identifier><identifier>DOI: 10.1177/2192568219865186</identifier><identifier>PMID: 32677573</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Back surgery ; Degenerative disc disease ; Original ; Spine ; Surgical techniques</subject><ispartof>Global spine journal, 2020-08, Vol.10 (5), p.603-610</ispartof><rights>The Author(s) 2019</rights><rights>The Author(s) 2019. This work is licensed under the Creative Commons Attribution – Non-Commercial – No Derivatives License https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). 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Results: In total, 25 levels were treated. No reoperation was required. Disc height was increased by an average of 25% (P &lt; .001). The canal area increased from 109 to 149 mm2 (P &lt; .001) and from 9.3 to 12.2 mm (P &lt; .001) in anteroposterior diameter. The foramen area demonstrated the effect of indirect decompression on both sides (P &lt; .001). The height of the foramen showed significant average increase of 2.8 mm (P &lt; .001). The results from VAS and ODI questionnaires confirmed the clinical effect of indirect decompression. 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subjects Back surgery
Degenerative disc disease
Original
Spine
Surgical techniques
title Clinical and Radiological Results After Minimally Invasive Transpsoas Lateral Access Surgery for Degenerative Lumbar Stenosis
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