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Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience

INTRODUCTION: Evaluating the effects of indirect decompression obtained through lateral lumbar interbody fusion (LLIF) by clinical improvements and radiological parameters on MRI scans. Identifying predictors of better decompression and clinical outcome. MATERIALS AND METHODS: From 2016 to 2019, pat...

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Autores principales: Petrone, Salvatore, Ajello, Marco, Marengo, Nicola, Bozzaro, Marco, Pesaresi, Alessandro, Allevi, Mario, Fiumefreddo, Alessandro, Denegri, Federica, Cogoni, Maurizio, Garnero, Andrea, Tartara, Fulvio, Di Perna, Giuseppe, Armocida, Daniele, Pesce, Alessandro, Frati, Alessandro, Zenga, Francesco, Garbossa, Diego, Cofano, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10106706/
https://www.ncbi.nlm.nih.gov/pubmed/37077862
http://dx.doi.org/10.3389/fsurg.2023.1158836
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author Petrone, Salvatore
Ajello, Marco
Marengo, Nicola
Bozzaro, Marco
Pesaresi, Alessandro
Allevi, Mario
Fiumefreddo, Alessandro
Denegri, Federica
Cogoni, Maurizio
Garnero, Andrea
Tartara, Fulvio
Di Perna, Giuseppe
Armocida, Daniele
Pesce, Alessandro
Frati, Alessandro
Zenga, Francesco
Garbossa, Diego
Cofano, Fabio
author_facet Petrone, Salvatore
Ajello, Marco
Marengo, Nicola
Bozzaro, Marco
Pesaresi, Alessandro
Allevi, Mario
Fiumefreddo, Alessandro
Denegri, Federica
Cogoni, Maurizio
Garnero, Andrea
Tartara, Fulvio
Di Perna, Giuseppe
Armocida, Daniele
Pesce, Alessandro
Frati, Alessandro
Zenga, Francesco
Garbossa, Diego
Cofano, Fabio
author_sort Petrone, Salvatore
collection PubMed
description INTRODUCTION: Evaluating the effects of indirect decompression obtained through lateral lumbar interbody fusion (LLIF) by clinical improvements and radiological parameters on MRI scans. Identifying predictors of better decompression and clinical outcome. MATERIALS AND METHODS: From 2016 to 2019, patients who underwent single- or double-level indirect decompression LLIF were consecutively reviewed. Radiological signs of indirect decompression were evaluated in preoperative and follow-up MRI studies and were subsequently correlated to clinical data, expressed as axial/radicular pain (VAS back/leg), index of disability (Oswestry Disability Index) and clinical severity of lumbar stenosis (Swiss Spinal Stenosis Questionnaire). RESULTS: 72 patients were enrolled. The mean follow-up was 24 months. Differences in vertebral canal area (p < 0.001), height of the foramina (p < 0.001), thickness of the yellow ligament (p = 0.001) and anterior height of the interbody space (p = 0.02) were observed. Older age (p = 0.042), presence of spondylolisthesis (p = 0.042), presence of intra-articular facet effusion (p = 0.003) and posterior height of the implanted cage (p = 0.020) positively affected the increase of the canal area. Change in root canal area (p < 0.001), height of the implanted cage (p = 0.020) and younger age (p = 0.035) were predictive factors of root pain relief, while increased vertebral canal area (p = 0.020) and height of the interbody fusion cage (p = 0.023) positively affected the severity of clinical stenosis. CONCLUSIONS: LLIF indirect decompression showed both clinical and radiological improvements. Presence and degree of spondylolisthesis, presence of intra-articular facet effusion, age of the patient and height of the cage were predictive factors of major clinical improvements.
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spelling pubmed-101067062023-04-18 Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience Petrone, Salvatore Ajello, Marco Marengo, Nicola Bozzaro, Marco Pesaresi, Alessandro Allevi, Mario Fiumefreddo, Alessandro Denegri, Federica Cogoni, Maurizio Garnero, Andrea Tartara, Fulvio Di Perna, Giuseppe Armocida, Daniele Pesce, Alessandro Frati, Alessandro Zenga, Francesco Garbossa, Diego Cofano, Fabio Front Surg Surgery INTRODUCTION: Evaluating the effects of indirect decompression obtained through lateral lumbar interbody fusion (LLIF) by clinical improvements and radiological parameters on MRI scans. Identifying predictors of better decompression and clinical outcome. MATERIALS AND METHODS: From 2016 to 2019, patients who underwent single- or double-level indirect decompression LLIF were consecutively reviewed. Radiological signs of indirect decompression were evaluated in preoperative and follow-up MRI studies and were subsequently correlated to clinical data, expressed as axial/radicular pain (VAS back/leg), index of disability (Oswestry Disability Index) and clinical severity of lumbar stenosis (Swiss Spinal Stenosis Questionnaire). RESULTS: 72 patients were enrolled. The mean follow-up was 24 months. Differences in vertebral canal area (p < 0.001), height of the foramina (p < 0.001), thickness of the yellow ligament (p = 0.001) and anterior height of the interbody space (p = 0.02) were observed. Older age (p = 0.042), presence of spondylolisthesis (p = 0.042), presence of intra-articular facet effusion (p = 0.003) and posterior height of the implanted cage (p = 0.020) positively affected the increase of the canal area. Change in root canal area (p < 0.001), height of the implanted cage (p = 0.020) and younger age (p = 0.035) were predictive factors of root pain relief, while increased vertebral canal area (p = 0.020) and height of the interbody fusion cage (p = 0.023) positively affected the severity of clinical stenosis. CONCLUSIONS: LLIF indirect decompression showed both clinical and radiological improvements. Presence and degree of spondylolisthesis, presence of intra-articular facet effusion, age of the patient and height of the cage were predictive factors of major clinical improvements. Frontiers Media S.A. 2023-04-03 /pmc/articles/PMC10106706/ /pubmed/37077862 http://dx.doi.org/10.3389/fsurg.2023.1158836 Text en © 2023 Petrone, Ajello, Marengo, Bozzaro, Pesaresi, Allevi, Fiumefreddo, Denegri, Cogoni, Garnero, Tartara, Di Perna, Armocida, Pesce, Frati, Zenga, Garbossa and Cofano. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Petrone, Salvatore
Ajello, Marco
Marengo, Nicola
Bozzaro, Marco
Pesaresi, Alessandro
Allevi, Mario
Fiumefreddo, Alessandro
Denegri, Federica
Cogoni, Maurizio
Garnero, Andrea
Tartara, Fulvio
Di Perna, Giuseppe
Armocida, Daniele
Pesce, Alessandro
Frati, Alessandro
Zenga, Francesco
Garbossa, Diego
Cofano, Fabio
Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience
title Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience
title_full Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience
title_fullStr Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience
title_full_unstemmed Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience
title_short Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience
title_sort clinical outcomes, mri evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10106706/
https://www.ncbi.nlm.nih.gov/pubmed/37077862
http://dx.doi.org/10.3389/fsurg.2023.1158836
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