Factors that influence the results of indirect decompression employing oblique lumbar interbody fusion  

作　　者：Andrey E Bokov Svetlana Y Kalinina Mingiyan I Khaltyrov Alexandr P Saifullin Anatoliy A Bulkin 

机构地区：[1]Department of Neurosurgery,Institute of Traumatology and Orthopedics,Privolzhsky Research Medical University,Nizhny Novgorod,603005,Russia [2]Department of Traumatology,Orthopedics and Neurosurgery,Privolzhsky Research Medical University,Nizhny Novgorod,603005,Russia

出　　处：《World Journal of Orthopedics》2024年第8期734-743,共10页世界骨科杂志（英文版）

摘　　要：BACKGROUND Indirect decompression is one of the potential benefits of anterior reconstruction in patients with spinal stenosis.On the other hand,the reported rate of revision surgery after indirect decompression highlights the necessity of working out prediction models for the radiographic results of indirect decompression with assessing their clinical relevance.AIM To assess factors that influence radiographic and clinical results of the indirect decompression in patients with stenosis of the lumbar spine.METHODS This study is a single-center cross-sectional evaluation of 80 consecutive patients(17 males and 63 females)with lumbar spinal stenosis combined with the instability of the lumbar spinal segment.Patients underwent single level or bisegmental spinal instrumentation employing oblique lumbar interbody fusion(OLIF)with percutaneous pedicle screw fixation.Radiographic results of the indirect decompression were assessed using computerized tomography,while MacNab scale was used to assess clinical results.RESULTS After indirect decompression employing anterior reconstruction using OLIF,the statistically significant increase in the disc space height,vertebral canal square,right and left lateral canal depth were detected(Р<0.0001).The median(M)relative vertebral canal square increase came toМ=24.5%with 25%-75%quartile border(16.3%;33.3%)if indirect decompression was achieved by restoration of the segment height.In patients with the reduction of the upper vertebrae slip,the median of the relative increase in vertebral canal square accounted for 49.5%with 25%-75%quartile border(2.35;99.75).Six out of 80 patients(7.5%)presented with unsatisfactory results because of residual nerve root compression.The critical values for lateral recess depth and vertebral canal square that were associated with indirect decompression failure were 3 mm and 80 mm2 respectively.CONCLUSION Indirect decompression employing anterior reconstruction is achieved by the increase in disc height along the posterior boarder and reduction of the

关 键 词：Indirect decompression Anterior reconstruction Central lumbar spinal stenosis Degenerative spondylolisthesis Lateral recess stenosis Spinal instability Oblique lateral interbody fusion 

分 类 号：R68[医药卫生—骨科学]