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| DONG Lüpeng,WANG Zhangfu,FENG Xingbing.Clinical outcome of lateral lumbar interbody fusion in the treatment of lumbar spinal stenosis with redundant nerve roots[J].Chinese Journal of Spine and Spinal Cord,2024,(1):46-52. |
| Clinical outcome of lateral lumbar interbody fusion in the treatment of lumbar spinal stenosis with redundant nerve roots |
| Received:April 03, 2023 Revised:October 18, 2023 |
| English Keywords:Lumbar spine Spinal stenosis Redundant nerve roots Spinal fusion |
| Fund:浙江省公益技术应用社发领域项目（编号：LGF21H060008） |
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| English Abstract: |
| 【Abstract】 Objectives: To investigate the clinical efficacy and outcome of lateral lumbar interbody fusion in the treatment of lumbar spinal stenosis(LSS) with redundant nerve roots(RNRs). Methods: The data of 48 LSS patients with RNRs(23 males and 25 females, aged 45-81 years, on average 65.4±7.5 years) treated with lateral lumbar interbody fusion between January 2018 and July 2022 in our hospital were analyzed retrospectively. Among the patients, 17 cases received single-level surgery and 31 cases received multi-level surgery. On the basis of the postoperative supine MRI scans, the patients were divided into RNRs relieved group(group A) and RNRs unrelieved group(group B). Radiographic assessments included disc heights, segmental angle and cross-sectional area of the spinal canal at the RNRs segment before and after operation were performed. The visual analogue scale(VAS), Oswestry disability index(ODI) and Japanese Orthopaedic Association(JOA) score were used to evaluate the clinical outcomes at preoperation and 1 month after surgery. Results: All patients underwent surgery successfully. The preoperative cross-sectional area of the spinal canal was 65.2±21.5mm2 in group A and 35.9±11.5mm2 in group B, with a significant difference(P＜0.05). The posterior disk height and cross-sectional area of the spinal canal was 8.3±1.7mm and 92.6±25.8mm2 respectively in group A, and that of group B was 6.0±2.3mm and 45.4±12.1mm2 respectively, the differences were significantly statistical(P＜0.05). Furthermore, in 1 month after operation the VAS leg pain, ODI and JOA scores was 2.4±0.8, (24.1±3.0)％ and 22.8±1.9 respectively in group A, and that of group B was 3.3±0.8, (30.2±4.4)％ and 17.7±2.5 respectively, the differences were significantly statistical(P＜0.05). The total incidence of complications was 10.4%, including anterolateral thigh pain in 4 cases and hip flexor weakness in 1 case, which were released at 3 months of follow-up. Conclusions: Lateral lumbar interbody fusion can eliminate RNRs by restoring postoperative posterior disc height and enlarging the cross-sectional area of spinal canal, which provides an effective treatment for most LSS patients with RNRs. |
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