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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

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  • Media type: E-Article
  • Title: Clinical outcomes, MRI evaluation and predictive factors of indirect decompression with lateral transpsoas approach for lumbar interbody fusion: a multicenter experience
  • Contributor: 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
  • imprint: Frontiers Media SA, 2023
  • Published in: Frontiers in Surgery
  • Language: Not determined
  • DOI: 10.3389/fsurg.2023.1158836
  • ISSN: 2296-875X
  • Keywords: Surgery
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Introduction</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Materials and methods</jats:title><jats:p>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).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>72 patients were enrolled. The mean follow-up was 24 months. Differences in vertebral canal area (<jats:italic>p</jats:italic> &amp;lt; 0.001), height of the foramina (<jats:italic>p</jats:italic> &amp;lt; 0.001), thickness of the yellow ligament (<jats:italic>p</jats:italic> = 0.001) and anterior height of the interbody space (<jats:italic>p</jats:italic> = 0.02) were observed. Older age (<jats:italic>p</jats:italic> = 0.042), presence of spondylolisthesis (<jats:italic>p</jats:italic> = 0.042), presence of intra-articular facet effusion (<jats:italic>p</jats:italic> = 0.003) and posterior height of the implanted cage (<jats:italic>p</jats:italic> = 0.020) positively affected the increase of the canal area. Change in root canal area (<jats:italic>p</jats:italic> &amp;lt; 0.001), height of the implanted cage (<jats:italic>p</jats:italic> = 0.020) and younger age (<jats:italic>p</jats:italic> = 0.035) were predictive factors of root pain relief, while increased vertebral canal area (<jats:italic>p</jats:italic> = 0.020) and height of the interbody fusion cage (<jats:italic>p</jats:italic> = 0.023) positively affected the severity of clinical stenosis.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>
  • Access State: Open Access