Does vacuum phenomenon at non-fused discs affect the postoperative course after transforaminal lumbar interbody fusion in patients showing a positive value of difference in lumbar lordosis?

Autor:	Ohyama S; Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan., Aoki Y; Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan; Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan. Electronic address: yasuaoki35@fc4.so-net.ne.jp., Inoue M; Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan; Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan., Nakajima T; Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan; Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan; Department of Orthopaedic Surgery, Oyumino Central Hospital, Chiba-city, Chiba, Japan., Sato Y; Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan; Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan., Sato M; Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan; Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan., Yoh S; Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan; Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan., Takahashi H; Department of Orthopaedic Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan., Nakajima A; Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Sakura, Chiba, Japan., Eguchi Y; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan., Orita S; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan., Inage K; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan., Shiga Y; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan., Nakagawa K; Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Sakura, Chiba, Japan., Ohtori S; Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba-city, Chiba, Japan.
Jazyk:	angličtina
Zdroj:	Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association [J Orthop Sci] 2024 Mar; Vol. 29 (2), pp. 472-479. Date of Electronic Publication: 2023 Jan 24.
DOI:	10.1016/j.jos.2023.01.001
Abstrakt:	Introduction: Preoperative difference in lumbar lordosis (DiLL) was associated with surgical outcomes after single-level transforaminal lumbar interbody fusion (TLIF). Patients with DiLL>0 (DiLL (+)) tended to show worse clinical outcomes and postoperative greater restoration of lumbar lordosis (LL). However, some patients with DiLL (+) showed relatively good outcomes and no postoperative LL restration. This study aimed to elucidate whether the lumbar intervertebral disc vacuum phenomenon (VP) influences clinical course after single-level TLIF in patients with DiLL (+) and DiLL (-). Methods: Patients with lumbar spinal stenosis and degenerative spondylolisthesis treated with single-level TLIF were included. Pre- and postoperative LL were measured, and postoperative LL improvement was calculated. Preoperative DiLL was calculated as preoperative supine LL minus standing LL. Severity of VP at the non-fused discs (SVP (non-FS)) was evaluated using preoperative reconstructed computed tomography imaging. Clinical outcomes were assessed using the Oswestry disability index, visual analogue scale (VAS; low back pain (LBP), lower-extremity pain, numbness, and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire. Patients were stratified by the median preoperative SVP (non-FS) score into severe and mild VP groups in patients with DiLL (+) or DiLL (-), and their surgical outcomes were compared. Results: Overall, 89 patients were included. In patients with DiLL (+) (n = 37), patients with severe VP showed worse clinical outcomes, particulary for LBP and DiLL (+) patients with mild VP showed greater LL improvement (6.5° ± 10.0°). In patients with DiLL(-) (n = 52), patients with severe VP showed worse clinical outcomes, particularly for LBP and no differences in preoperative, postoperative, and improvement of LL were observed between two groups. Conclusion: Patients with DiLL (+) and DiLL (-) showed different clinical courses depending on VP severity at the non-fused discs after single-level TLIF. Competing Interests: Declaration of competing interest None. (Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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