Factors affecting the height of early intervertebral space after lumbar interbody fusion via lateral approach

doi:10.3969/j.issn.2095-4344.3868

Abstract

Abstract: BACKGROUND: Mechanical loading could naturally cause postoperative disc height loss. Two main reasons causing this phenomenon were yielding of the polyaxial screw head and settling of the cage to the endplate. When cage subsidence appeared, significant reduction in the interbody space would emerge, which would compromise the indirect decompression.
OBJECTIVE: To analyze the factors affecting the disc height loss after lateral lumbar interbody fusion in the early follow-up.
METHODS: Totally 37 patients (22 males and 15 females with the mean age of 62.3±9.2 years) with degenerated lumber disease, who were treated with single or multi segmental lateral lumbar interbody fusion combined with posterior internal fixation in Qinghai Red Cross Hospital from January to December 2018, were included in this study. There were totally 72 fusion segments. Anterior disc height, posterior disc height, mean disc height, disc space angle, and segmental angle were measured on lateral plain X-ray images before, immediately, 1, 3, and 6 months after operation. The correlation of disc height loss with age, constructed segment length, preoperative lordosis, postoperative lordosis, disc height, cage parameters, and cage position was analyzed.
RESULTS AND CONCLUSION: (1) Cage placement in lateral lumbar interbody fusion significantly increased anterior disc height, posterior disc height, mean disc height, and disc space angle after surgery (P < 0.05). (2) There was a significant positive correlation between disc height parameters, especially the amount of mean disc height increase, and disc height loss after operation (r=0.413, P < 0.05). (3) Segments demonstrating significant height loss (≥25%) also achieved remarkable height increase immediately after operation, which increased by 135.6% from (4.5±3.0) mm to (10.5±5.3) mm. Otherwise, segments with height loss less than 25% had only 57.4% in postoperative height increase. (4) The greater the postoperative disc height increase, the greater the disc height loss across early follow-up. (5) Therefore, it is important to achieve a proper intervertebral space height rather than overcorrection when determining surgical strategy for lateral lumbar interbody fusion.

Key words: lumbar vertebrae, degenerated lumber disease, lateral approach, intervertebral fusion, internal fixation, intervertebral space height

CLC Number:

Zhao Hongshun, A Jiancuo, Wang Deyuan, Xu Zhihua, Gao Shunhong. Factors affecting the height of early intervertebral space after lumbar interbody fusion via lateral approach[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(21): 3332-3336.

Figures/Tables 4

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