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Eguchi Y, Suzuki N, Orita S, Inage K, Narita M, Shiga Y, Inoue M, Toshi N, Tokeshi S, Okuyama K, Ohyama S, Maki S, Aoki Y, Nakamura J, Hagiwara S, Kawarai Y, Akazawa T, Koda M, Takahashi H, Ohtori S. Short-Term Clinical and Radiographic Evaluation of Patients Treated With Expandable and Static Interbody Spacers Following Lumbar Lateral Interbody Fusion. World Neurosurg 2024:S1878-8750(24)00424-8. [PMID: 38493893 DOI: 10.1016/j.wneu.2024.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/10/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE The goal of this study was to evaluate, using computed tomography (CT) and magnetic resonance imaging (MRI), patients who underwent oblique lateral interbody fusion (OLIF) using either expandable or static interbody spacers. METHODS Thirty-five patients with degenerative disc disease were surgically treated with one-level OLIF and were followed up for more than 6 months. The Static group consisted of 22 patients, and 13 patients were in the Expandable group. Intraoperative findings included operative time (min), blood loss (ml), and cage size. Low back pain, leg pain, and leg numbness were measured using the Japanese Orthopedic Association score, visual analogue score, and the Roland-Morris Disability Questionnaire. Radiologic evaluation using computed tomography (CT) and magnetic resonance imaging (MRI) allowed measurement of cage subsidence, cross-sectional area (CSA) of the dural sac, disc height, segmental lordosis, foraminal height, and foraminal CSA preoperatively and 6 months postoperatively. RESULTS The Expandable group had significantly larger cage height and lordosis than the Static group (P < 0.05). The Expandable group also had greater dural sac area expansion and enlargement of the intervertebral foramen, as well as better correction of vertebral body slip (P < 0.05). Cage subsidence was significantly lower in the Expandable group (P < 0.05). JOA and VAS scores for leg numbness were significantly better in the Expandable group (P < 0.05). CONCLUSIONS Compared with static spacers, expandable spacers significantly enlarged the dural sac area, corrected vertebral body slippage, expanded the intervertebral foramen, and achieved good indirect decompression while reducing cage subsidence, resulting in improvement in clinical symptoms.
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Affiliation(s)
- Yawara Eguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan; Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido, Chiba, Japan.
| | - Noritaka Suzuki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan; Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Miyako Narita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Masahiro Inoue
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Noriyasu Toshi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Soichiro Tokeshi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Kohei Okuyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Shuhei Ohyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Satoshi Maki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Yasuchika Aoki
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan
| | - Junichi Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Shigeo Hagiwara
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Yuya Kawarai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Tsutomu Akazawa
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Masao Koda
- Department of Orthopedic Surgery, University of Tsukuba, Tsukuba-City, Ibaraki, Japan
| | - Hiroshi Takahashi
- Department of Orthopedic Surgery, University of Tsukuba, Tsukuba-City, Ibaraki, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
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