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Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches

Background: Different surgical approaches are available for lumbar interbody fusion (LIF) to treat disc degeneration. However, a quantification of their invasiveness is lacking, and the definition of minimally invasive surgery (MIS) has not been biochemically detailed. We aimed at characterizing the...

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Autores principales: Lombardi, Giovanni, Berjano, Pedro, Cecchinato, Riccardo, Langella, Francesco, Perego, Silvia, Sansoni, Veronica, Tartara, Fulvio, Regazzoni, Pietro, Lamartina, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303236/
https://www.ncbi.nlm.nih.gov/pubmed/34300294
http://dx.doi.org/10.3390/jcm10143128
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author Lombardi, Giovanni
Berjano, Pedro
Cecchinato, Riccardo
Langella, Francesco
Perego, Silvia
Sansoni, Veronica
Tartara, Fulvio
Regazzoni, Pietro
Lamartina, Claudio
author_facet Lombardi, Giovanni
Berjano, Pedro
Cecchinato, Riccardo
Langella, Francesco
Perego, Silvia
Sansoni, Veronica
Tartara, Fulvio
Regazzoni, Pietro
Lamartina, Claudio
author_sort Lombardi, Giovanni
collection PubMed
description Background: Different surgical approaches are available for lumbar interbody fusion (LIF) to treat disc degeneration. However, a quantification of their invasiveness is lacking, and the definition of minimally invasive surgery (MIS) has not been biochemically detailed. We aimed at characterizing the inflammatory, hematological, and clinical peri-surgical responses to different LIF techniques. Methods: 68 healthy subjects affected by single-level discopathy (L3 to S1) were addressed to MIS, anterior (ALIF, n = 21) or lateral (LLIF, n = 23), and conventional approaches, transforaminal (TLIF, n = 24), based on the preoperative clinical assessment. Venous blood samples were taken 24 h before the surgery and 24 and 72 h after surgery to assess a wide panel of inflammatory and hematological markers. Results: martial (serum iron and transferrin) and pro-angiogenic profiles (MMP-2, TWEAK) were improved in ALIF and LLIF compared to TLIF, while the acute phase response (C-reactive protein, sCD163) was enhanced in LLIF. Conclusions: MIS procedures (ALIF and LLIF) associated with a reduced incidence of post-operative anemic status, faster recovery, and enhanced pro-angiogenic stimuli compared with TLIF. LLIF associated with an earlier activation of innate immune mechanisms than ALIF and TLIF. The trend of the inflammation markers confirms that the theoretically defined mini-invasive procedures behave as such.
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spelling pubmed-83032362021-07-25 Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches Lombardi, Giovanni Berjano, Pedro Cecchinato, Riccardo Langella, Francesco Perego, Silvia Sansoni, Veronica Tartara, Fulvio Regazzoni, Pietro Lamartina, Claudio J Clin Med Article Background: Different surgical approaches are available for lumbar interbody fusion (LIF) to treat disc degeneration. However, a quantification of their invasiveness is lacking, and the definition of minimally invasive surgery (MIS) has not been biochemically detailed. We aimed at characterizing the inflammatory, hematological, and clinical peri-surgical responses to different LIF techniques. Methods: 68 healthy subjects affected by single-level discopathy (L3 to S1) were addressed to MIS, anterior (ALIF, n = 21) or lateral (LLIF, n = 23), and conventional approaches, transforaminal (TLIF, n = 24), based on the preoperative clinical assessment. Venous blood samples were taken 24 h before the surgery and 24 and 72 h after surgery to assess a wide panel of inflammatory and hematological markers. Results: martial (serum iron and transferrin) and pro-angiogenic profiles (MMP-2, TWEAK) were improved in ALIF and LLIF compared to TLIF, while the acute phase response (C-reactive protein, sCD163) was enhanced in LLIF. Conclusions: MIS procedures (ALIF and LLIF) associated with a reduced incidence of post-operative anemic status, faster recovery, and enhanced pro-angiogenic stimuli compared with TLIF. LLIF associated with an earlier activation of innate immune mechanisms than ALIF and TLIF. The trend of the inflammation markers confirms that the theoretically defined mini-invasive procedures behave as such. MDPI 2021-07-15 /pmc/articles/PMC8303236/ /pubmed/34300294 http://dx.doi.org/10.3390/jcm10143128 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lombardi, Giovanni
Berjano, Pedro
Cecchinato, Riccardo
Langella, Francesco
Perego, Silvia
Sansoni, Veronica
Tartara, Fulvio
Regazzoni, Pietro
Lamartina, Claudio
Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches
title Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches
title_full Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches
title_fullStr Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches
title_full_unstemmed Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches
title_short Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches
title_sort peri-surgical inflammatory profile associated with mini-invasive or standard open lumbar interbody fusion approaches
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303236/
https://www.ncbi.nlm.nih.gov/pubmed/34300294
http://dx.doi.org/10.3390/jcm10143128
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