Excessive Fluid in the Lumbar Facet Joint as a Predictor of Radiological Outcomes After Lateral Lumbar Interbody Fusion.

Autor: Angel Roldan M; Neurological Surgery, Weill Cornell Brain and Spine Center, New York, USA., Atalay B; Neurological Surgery, Weill Cornell Brain and Spine Center, New York , USA., Navarro-Ramirez R; Orthopedics/Spine, McGill, Montreal, CAN., Kirnaz S; Neurological Surgery, Weill Cornell Brain and Spine Center, New York , USA., Medary B; Neurological Surgery, Weill Cornell Brain and Spine Center, New York , USA., Sommer F; Neurological Surgery, Weill Cornell Medical College-New York Presbyterian Hospital, New York , USA., Gadjradj PS; Neurological Surgery, Weill Cornell Brain and Spine Center, New York, USA., Härtl R; Neurological Surgery, Weill Cornell Medical College-New York Presbyterian Hospital,, New York, USA.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2022 Oct 12; Vol. 14 (10), pp. e30217. Date of Electronic Publication: 2022 Oct 12 (Print Publication: 2022).
DOI: 10.7759/cureus.30217
Abstrakt: Background Preoperative segmental instability maybe a predictor of postoperative outcomes when treated with lateral lumbar interbody fusion (LLIF). An abnormal collection of fluid within the facet joint has been described as a sign of segmental instability. The potential relationship between this radiological sign and its prognostic relevance for indirect decompression (ID) has not been investigated. Methods Clinical and radiologic results from patients undergoing LLIF in a single institution between 2007 and 2014 were evaluated retrospectively. Patients were divided into two groups: those presenting with excessive fluid (EF) in the facet joints on T2-MRI and those with a normal amount of facet fluid with less than 1mm, which were controls. Radiological parameters were foraminal height, disc height, Cobb angle, and lumbar lordosis. Results A total of 21 patients (43 operated levels) were evaluated pre- and postoperatively. Mean disc height, mean foraminal height, and coronal Cobb angles were statistically significantly improved after LLIF. Only the EF group showed significant improvement in radiological markers after ID; the mean disc height improved from 5.5±2 to 8.8±1mm (p=0.001), mean foraminal height improved from 16.88±3 to 20.53±3mm (p=0.002), and the mean Cobb angle improved from 27.7±16 to 14±13 (p=0.018). Conclusions Patients undergoing LLIF with the radiological findings of EF in the facet joints demonstrated significant improvement in radiological outcomes of ID. Further studies should validate these findings in larger data sets.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2022, Angel Roldan et al.)
Databáze: MEDLINE