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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 584 - 591 (8page)
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초록· 키워드
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Study Design: Prospective cohort study. Purpose: This study aimed to identify risk factors for unplanned second-stage decompression for postoperative neurological deficit after indirect decompression using lateral lumbar interbody fusion (LLIF) with posterior fixation. Overview of Literature: Indirect lumbar decompression with LLIF has been used as a minimally invasive alternative to direct decompression to treat degenerative lumbar diseases requiring neural decompression. However, evidence on the prevalence of neurological deficits caused by spinal canal stenosis after indirect decompression is limited. Methods: This study included 158 patients (mean age, 71.13±7.98 years; male/female ratio, 67/91) who underwent indirect decompression with LLIF and posterior fixation. Indirect decompression was performed at 271 levels (mean level, 1.71±0.97). Logistic regression analysis was used to identify the risk factors for postoperative neurological deficits. The variables included were age, sex, body mass index, presence of primary diseases, diabetes mellitus, preoperative motor deficit, levels operated on, preoperative severity of lumbar stenosis, and preoperative Japanese Orthopedic Association (JOA) score. Results: Postoperative neurological deficit due to spinal canal stenosis occurred in three patients (1.9%). Spinal stenosis due to hemodialysis (p<0.001), ligament ossification (p<0.001), presence of preoperative motor paralysis (p<0.001), low JOA score (p=0.004), and severe canal stenosis (p=0.02) were significantly more frequent in the paralysis group. Conclusions: Severe preoperative canal stenosis and neurological deficit were identified as risk factors for postoperative neurological deterioration caused by spinal canal stenosis. Additionally, uncommon diseases, such as spinal stenosis due to hemodialysis and ligament ossification, increased the risk of postoperative neurological deficit; therefore, in such cases, indirect decompression is contraindicated.
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참고문헌 (15)
참고문헌 신청
Ozgur BM / 2006 / Extreme lateral interbody fusion(XLIF) : a novel surgical technique for anterior lumbar interbody fusion / Spine J 6:435~443
Oliveira L / 2010 / A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements / Spine(Phila Pa 1976) 35:S331~S337
Abhijit Y. Pawar / 2015 / A Comparative Study of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion in Degenerative Lumbar Spondylolisthesis / Asian Spine Journal 9(5):668~674
Fujibayashi S / 2015 / Effect of indirect neural decompression through oblique lateral interbody fusion for degenerative lumbar disease / Spine(Phila Pa 1976) 40:E175~E182
Epstein NE / 2016 / Extreme lateral lumbar interbody fusion:do the cons outweigh the pros? / Surg Neurol Int 7:S692~S700
Oliveira L / 2010 / A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements / Spine(Phila Pa 1976) 35:S331~S337
Abhijit Y. Pawar / 2015 / A Comparative Study of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion in Degenerative Lumbar Spondylolisthesis / Asian Spine Journal 9(5):668~674
Fujibayashi S / 2015 / Effect of indirect neural decompression through oblique lateral interbody fusion for degenerative lumbar disease / Spine(Phila Pa 1976) 40:E175~E182
Epstein NE / 2016 / Extreme lateral lumbar interbody fusion:do the cons outweigh the pros? / Surg Neurol Int 7:S692~S700
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