Objective There is a lack of literature on indirect decompression in uniportal endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF). Our aim is to evaluate the dimensions of the spinal canal and contralateral foramen before and after EPTLIF.
Methods This is a retrospective study of patients who underwent EPTLIF in a tertiary spine centre over a 2-year period. The cross-sectional area of the spinal canal and the contralateral foramen at the level of fusion were measured on magnetic resonance imaging scan at 1-day postoperation and at the final follow-up. Patients were grouped according to the decompression performed as per the clinician’s judgement.
Results One hundred fifty-two levels of fusion were performed in 120 patients. There was a statistically significant clinical improvement in visual analogue scale and Oswestry Disability Index scores postoperation. The measurements of the spinal canal area were 106.0 mm2, 138.8 mm2, and 195.5 mm2; while contralateral foraminal area were 73.2 mm2, 104.4 mm2, and 120.7 mm2 at preoperation, 1-day postoperation, and at the final follow-up, respectively (p < 0.001). For the subgroup analyses, spinal canal area measurements for the bilateral decompression cohort (n = 35) were 57.0 mm2, 123.9 mm2, and 191.8 mm2; for the ipsilateral decompression cohort (n = 42) were 89.3 mm2, 128.9 mm2, 183.3 mm2; and for the cohort without any decompression and only cage inserted (n = 75) were 138.3 mm2, 151.2 mm2, and 204.1 mm2 (p < 0.001). Contralateral foraminal area measurements were 73.3 mm2, 106.4 mm2 and 120.4 mm2 in the bilateral decompression cohort; 69.5 mm2, 99.0 mm2, 116.9 mm2 in the ipsilateral decompression cohort; and 75.1 mm2, 106.5 mm2, 122.9 mm2 in the cohort without any decompression (p < 0.001).
Conclusion Indirect decompression of both the spinal canal and the contralateral foramen can be achieved via EPTLIF. Decompression on an asymptomatic contralateral side is not necessary.
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Results Among the 227 patients reviewed, 142 (62.6%) had a standard dermatomal pattern, and 74 of 110 (67.3%) had a standard myotomal pattern. The myotome of C5/6 radiculopathy showed much more variance than those of other cervical segments. Among the patients with severe motor weakness (muscle strength ≤ grade 3 or obvious muscle atrophy), all those with involvement of root C5, C7, and C8 showed a typical pattern (C4/5: 13 of 13 patients, C6/7: 5 of 5 patients, C7/T1: 3 of 3 patients), while only 2 of the 6 patients (33.3%) with severe motor weakness caused by C5/6 radiculopathy fit the typical pattern.
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Ossification of the posterior longitudinal ligament (OPLL) is a rare but potentially devastating cause of degenerative cervical myelopathy (DCM). Decompressive surgery is the standard of care for OPLL and can be achieved through anterior, posterior, or combined approaches to the cervical spine. Surgical correction of OPLL via any approach is associated with higher rates of complications and the presence of OPLL is considered a significant risk factor for perioperative complications in DCM surgeries. Potential complications include dural tear (DT) and subsequent cerebrospinal fluid leak, C5 palsy, hematoma, hardware failure, surgical site infections, and other neurological deficits. Anterior approaches are technically more demanding and associated with higher rates of DT but offer greater access to ventral OPLL pathology. Posterior approaches are associated with lower rates of complications but may allow for continued disease progression. Therefore, the decision to pursue either an anterior or posterior approach to surgical decompression may be critically influenced by complications associated with each procedure. The authors critically review anterior and posterior approaches to surgical decompression of OPLL with particular focus on the complications associated with each approach. We also review the recent work in developing new surgical treatments for OPLL that aim to reduce complication incidence.
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Objective To review concepts of a standalone endoscopically assisted lumbar interbody fusion as a simplified method to treat spinal instability.
Methods MacNab outcomes and complications were analyzed in a series of 48 consecutive patients who underwent standalone lordotic endoscopic wedge lumbar interbody fusion (LEW-LIF) for advanced lumbar disc degeneration, spinal stenosis, and spondylolisthesis.
Results Forty-two of the 48 patients (77.8%) did well with excellent and good outcomes with a follow up of up to 20 months. Fair outcomes were reported by 4, and poor by another 2 patients, respectively. Six patients had endoscopic decompression procedures at another level. Four patients underwent open transforaminal lumbar interbody fusion revision surgery including the index level between 2 to 6 months postoperatively. An L5 vertebral body fracture was noted in 1 of these 4 patients. Another patient underwent removal of the extruded L3/4 cage. The cage fractured in one additional asymptomatic patient not requiring any intervention. No patient had a wound infection, or permanent sensory, or motor dysfunction. However, 29 patients developed a postoperative irritation of the dorsal root ganglion with burning leg pain typically between postoperative weeks 2 and 6. Symptoms were treated with activity modification, gabapentin, and transforaminal epidural steroid injections in 12 patients (25%).
Conclusion Standalone LEW-LIF was associated with favorable clinical outcomes in the majority of patients. Patient-related predictors of less favorable outcomes considering normal variations as well as patho-anatomy may aid in the development of next-generation implants.
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Objective Mechanical alterations of the spine, which can cause chronic low back pain (LBP), are a frequent indication for spinal fusion. Studies have shown differences between genders in patients’ evaluations of health-related quality of life (HRQoL) after spinal procedures, but results have been conflicting, and some authors have suggested that cultural variation could explain these discrepancies. The objectives of this study were to determine the influence that gender plays on HRQoL, disability, and the correlation between the 2 in people undergoing spinal fusion for chronic LBP at a neurosurgical centre in Eastern Europe.
Methods Patients undergoing fusion surgery at a single centre for LBP with a duration of more than 3 months were included. They were evaluated using the Short Form Health Survey version-2.0 (SF-36v2) and Oswestry Low Back Pain Disability Index (ODI) questionnaire preoperatively and 1 year after the surgical procedure to identify differences between genders and to evaluate correlations between disability and quality of life.
Results We included 31 female and 30 male patients. The male patients had higher disability scores at the preoperative evaluation, but improved more than females in all domains of disability at the postoperative evaluation. HRQoL improved similarly in both genders. The ODI score showed a strong or moderate correlation with 6 of the domains of the SF-36 in males, but with only 3 domains in females. Surgery had a positive impact on the mental status of more men than women at risk of depression.
Conclusion The type of benefit that surgery offers seems to be influenced by gender. While HRQoL improved in both genders, disability decreased significantly more in male patients. Male patients also showed a closer correlation between HRQoL and disability. We conclude that men and women place different importance on specific aspects of their overall quality of life.
Citations
Citations to this article as recorded by
Gender Differences in Outcomes in Patients Treated for Thoracolumbar Burst Fractures Without Neurological Deficits: Prospective International Multicenter Study Charlotte Dandurand, Marcel F. Dvorak, Cumhur F. Öner, Dimitri Hauri, Klaus Schnake, Alexander R. Vaccaro, Lorin M. Benneker, Gregory D. Schroeder, Shanmuganathan Rajasekaran, Mohammad El-Skarkawi, Rishi M. Kanna, Eugen Cezar Popescu, Jin Wee Tee, Andrei Neurosurgery.2025; 97(3): 627. CrossRef
Effect of preoperative mental health status on spine surgery outcomes: a systematic review Tarek Nahle, Mohammad Daher, Ziad Zalaquett, Marven Aoun, Marc Moussallem, Remy Daou, Alan H Daniels, Amer Sebaaly BMC Surgery.2025;[Epub] CrossRef
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