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논문 기본 정보

자료유형
학술저널
저자정보
Seiji Ohtori (Chiba University) Sumihisa Orita (Chiba University) Kazuyo Yamauchi (Chiba University) Yawara Eguchi (Chiba University) Yasuchika Aoki (Chiba University) Junichi Nakamura (Chiba University) Masayuki Miyagi (Chiba University) Miyako Suzuki (Chiba University) Gou Kubota (Chiba University) Kazuhide Inage (Chiba University) Takeshi Sainoh (Chiba University) Jun Sato (Chiba University) Kazuki Fujimoto (Chiba University) Yasuhiro Shiga (Chiba University) Koki Abe (Chiba University) Hiroto Kanamoto (Chiba University) Gen Inoue (Chiba University) Kazuhisa Takahashi (Chiba University) Takeo Furuya (Chiba University) Masao Koda (Chiba University)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.11 No.1
발행연도
2017.1
수록면
105 - 112 (8page)

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Study Design: Retrospective case series. Purpose: The purpose of this study was to examine changes in the ligamentum flavum thickness and remodeling of the spinal canal after anterior fusion during a 10-year follow-up. Overview of Literature: Extreme lateral interbody fusion provides minimally invasive treatment of the lumbar spine; this anterior fusion without direct posterior decompression, so-called indirect decompression, can achieve pain relief. Anterior fusion may restore disc height, stretch the flexure of the ligamentum flavum, and increase the spinal canal diameter. However, changes in the ligamentum flavum thickness and remodeling of the spinal canal after anterior fusion during a long follow-up have not yet been reported. Methods: We evaluated 10 patients with L4 spondylolisthesis who underwent stand-alone anterior interbody fusion using the iliac crest bone. Magnetic resonance imaging was performed 10 years after surgery. The cross-sectional area (CSA) of the dural sac and the ligamentum flavum at L1–2 to L5–S1 was calculated using a Picture Archiving and Communication System. Results: Spinal fusion with correction loss (average, 4.75 mm anterior slip) was achieved in all patients 10 years postsurgery. The average CSAs of the dural sac and the ligamentum flavum at L1–2 to L5–S1 were 150 mm2 and 78 mm2, respectively. The average CSA of the ligamentum flavum at L4–5 (30 mm2) (fusion level) was significantly less than that at L1–2 to L3–4 or L5–S1. Although patients had an average anterior slip of 4.75 mm, the average CSA of the dural sac at L4–5 was significantly larger than at the other levels. Conclusions: Spinal stability induced a lumbar ligamentum flavum change and a sustained remodeling of the spinal canal, which may explain the long-term pain relief after indirect decompression fusion surgery.

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