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Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion
OBJECTIVE: Lumbar sympathetic trunk (LST) injury is one of the major complications after oblique lumbar interbody fusion (OLIF). LST injury often manifests as unequal skin temperature in lower limbs after operation, and there may be a large number of missed diagnoses due to the lack of attention and...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons Australia, Ltd
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102305/ https://www.ncbi.nlm.nih.gov/pubmed/36855251 http://dx.doi.org/10.1111/os.13692 |
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author | Pan, Qunlong Yu, Haiming He, Xiaoyu Weng, Yiyong Zhang, Rongmou Wang, Hanshi Li, Yizhong |
author_facet | Pan, Qunlong Yu, Haiming He, Xiaoyu Weng, Yiyong Zhang, Rongmou Wang, Hanshi Li, Yizhong |
author_sort | Pan, Qunlong |
collection | PubMed |
description | OBJECTIVE: Lumbar sympathetic trunk (LST) injury is one of the major complications after oblique lumbar interbody fusion (OLIF). LST injury often manifests as unequal skin temperature in lower limbs after operation, and there may be a large number of missed diagnoses due to the lack of attention and different diagnostic methods. The study aimed to investigate the incidence and clinical characteristics of LST injury after OLIF. METHODS: The data of patients with lumbar degenerative diseases who underwent OLIF in our hospital from April 2016 to October 2017 were retrospectively analyzed. Finally, a total of 54 patients were included. There were 10 males and 44 females, aged 58.4 ± 10.9 years. The skin temperature of lower limbs was measured before and a day after surgery. The patients were followed up at 1 week, 6 weeks, 6 months, and 2 years after the surgery. Likert five‐point scale was used to evaluate the discomfort caused by LST injury. Injury severity score was introduced to grade injury degree according to the recovery time of postoperative symptoms. The chi‐square test was used to analyze the association of incidence of lumbar sympathetic trunk (LST) injury with contributing factors, such as gender and number of surgical segments. RESULTS: The unequal temperature was not found before surgery in all the patients. Postoperatively, 16 cases (29.6%) had difference of skin temperature more than 0.5 °C and were diagnosed with LST injury. Eight patients (14.8%) had self‐perception of skin temperature differences, and 12 patients (22.2%) had other symptoms, such as muscle pain, numbness, and weakness, which were not statistically different between patients with and without lumbar sympathetic trunk injury (p > 0.05). In the 16 patients with LST injury, the difference of skin temperature between the two legs was 0.6 ± 0.1 °C on the first day, and the temperature difference lasted for 1.5–~12 months. According to Likert five‐point scale, two cases (12.5%) were poor, and 14 cases (87.5%) were moderate immediately after surgery. Fifteen cases improved to some extent 6 weeks to 12 months after surgery. CONCLUSION: Postoperative LST injury is mainly manifested by different temperature of lower limbs. The incidence was higher in patients with multi‐segment OLIF than in those with single‐segment OLIF, and the subjective experience of most patients with LST injury was moderate discomfort. |
format | Online Article Text |
id | pubmed-10102305 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley & Sons Australia, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-101023052023-04-15 Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion Pan, Qunlong Yu, Haiming He, Xiaoyu Weng, Yiyong Zhang, Rongmou Wang, Hanshi Li, Yizhong Orthop Surg Clinical Articles OBJECTIVE: Lumbar sympathetic trunk (LST) injury is one of the major complications after oblique lumbar interbody fusion (OLIF). LST injury often manifests as unequal skin temperature in lower limbs after operation, and there may be a large number of missed diagnoses due to the lack of attention and different diagnostic methods. The study aimed to investigate the incidence and clinical characteristics of LST injury after OLIF. METHODS: The data of patients with lumbar degenerative diseases who underwent OLIF in our hospital from April 2016 to October 2017 were retrospectively analyzed. Finally, a total of 54 patients were included. There were 10 males and 44 females, aged 58.4 ± 10.9 years. The skin temperature of lower limbs was measured before and a day after surgery. The patients were followed up at 1 week, 6 weeks, 6 months, and 2 years after the surgery. Likert five‐point scale was used to evaluate the discomfort caused by LST injury. Injury severity score was introduced to grade injury degree according to the recovery time of postoperative symptoms. The chi‐square test was used to analyze the association of incidence of lumbar sympathetic trunk (LST) injury with contributing factors, such as gender and number of surgical segments. RESULTS: The unequal temperature was not found before surgery in all the patients. Postoperatively, 16 cases (29.6%) had difference of skin temperature more than 0.5 °C and were diagnosed with LST injury. Eight patients (14.8%) had self‐perception of skin temperature differences, and 12 patients (22.2%) had other symptoms, such as muscle pain, numbness, and weakness, which were not statistically different between patients with and without lumbar sympathetic trunk injury (p > 0.05). In the 16 patients with LST injury, the difference of skin temperature between the two legs was 0.6 ± 0.1 °C on the first day, and the temperature difference lasted for 1.5–~12 months. According to Likert five‐point scale, two cases (12.5%) were poor, and 14 cases (87.5%) were moderate immediately after surgery. Fifteen cases improved to some extent 6 weeks to 12 months after surgery. CONCLUSION: Postoperative LST injury is mainly manifested by different temperature of lower limbs. The incidence was higher in patients with multi‐segment OLIF than in those with single‐segment OLIF, and the subjective experience of most patients with LST injury was moderate discomfort. John Wiley & Sons Australia, Ltd 2023-02-28 /pmc/articles/PMC10102305/ /pubmed/36855251 http://dx.doi.org/10.1111/os.13692 Text en © 2023 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Clinical Articles Pan, Qunlong Yu, Haiming He, Xiaoyu Weng, Yiyong Zhang, Rongmou Wang, Hanshi Li, Yizhong Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion |
title | Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion |
title_full | Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion |
title_fullStr | Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion |
title_full_unstemmed | Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion |
title_short | Lumbar Sympathetic Trunk Injury: An Underestimated Complication of Oblique Lateral Interbody Fusion |
title_sort | lumbar sympathetic trunk injury: an underestimated complication of oblique lateral interbody fusion |
topic | Clinical Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102305/ https://www.ncbi.nlm.nih.gov/pubmed/36855251 http://dx.doi.org/10.1111/os.13692 |
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