| Autor: |
SATOSHI HATTORI, AKAHI TANOUE, FUTOHI WATANABE, KEIJI WADA, SHUNICHI MORI |
| Předmět: |
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| Zdroj: |
International Journal of Spine Surgery; Oct2024, Vol. 18 Issue 5, p521-532, 12p |
| Abstrakt: |
Background: his study aimed to clarify the quantitative threshold of intraoperative radiological parameters for suspecting posterior malposition of the oblique lumbar interbody fusion (LF) cage triggering contralateral radiculopathy. Methods: We measured the sagittal center and axial rotation angle () of the cage using postoperative computed tomography () in 130 patients (215 cages) who underwent LF. he location of the cage tip was determined from axial magnetic resonance imaging in selected cases based on simulations to assess whether the cage was in contact with the contralateral exiting nerve or whether the surgical instruments could contact the nerve during intradiscal maneuvers. Results: he sagittal center of the cages was on average 41.5% from the anterior edge of the endplate (shown as / P value: anterior end plate edge-cage center/anterior-posterior endplate edge ×100%), and posterior cage positioning ≥50% occurred in 14% of the cages. he was -2.9°, and posterior oblique rotation of the cages ≥10° ( ≤ -10°) was observed in 13%. simulation showed that the cage tip could directly contact the contralateral nerve when the cage was placed deep in the posterior portion ≥50% of the /P values with concomitant posterior axial rotation ≥10° ( ≤ -10°), or deep in an extremely rare portion ≥60% of the /P values with posterior axial rotation ≥0° ( ≤ 0°). Six percent of the cages (13/215) were placed in these posterior oblique areas (potential contact area: P). hree cages in the P were in direct contact with the contralateral nerves, and 9 were placed deep just anterior to the nerves. Symptomatic contralateral radiculopathy occurred in 2 cages (2/13/215, 15.3%/0.9%). Conclusions: wo intraoperative radiological parameters (/P and ) measurable during LF procedures may become practical indicators for suspecting cage malposition in P and may be available when determining whether to consider cage revision intraoperatively to a more ventral disc space or anteriorly from the opposite endplate edge. Level of Evidence: 4. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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