Journal of Korean Neurosurgical Society

  • 제58권4호
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  • Pages.350-356
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  • 2015
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion

  • Jang, Kyoung-Min (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Park, Seung-Won (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Kim, Young-Baeg (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Park, Yong-Sook (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Nam, Taek-Kyun (Department of Neurosurgery, College of Medicine, Chung-Ang University) ;
  • Lee, Young-Seok (Department of Neurosurgery, College of Medicine, Chung-Ang University)
  • 투고 : 2015.07.01
  • 심사 : 2015.10.12
  • 발행 : 2015.10.28
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초록

Objective : Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods : We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results : Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion : The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.

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참고문헌

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피인용 문헌

  1. Comparison of Clinical and Radiological Outcomes of Lumbar Interbody Fusion Using a Combination of Hydroxyapatite and Demineralized Bone Matrix and Autografts for Lumbar Degenerative Spondylolisthesis vol.11, pp.5, 2015, https://doi.org/10.4184/asj.2017.11.5.706
  2. Risk factor of contralateral radiculopathy following microendoscopy-assisted minimally invasive transforaminal lumbar interbody fusion vol.27, pp.8, 2018, https://doi.org/10.1007/s00586-017-5417-8
  3. Morphological changes of contralateral intervertebral foramen induced by cage insertion orientation after unilateral transforaminal lumbar interbody fusion vol.14, pp.None, 2019, https://doi.org/10.1186/s13018-019-1121-1
  4. Risk Factors for Symptomatic Contralateral Foraminal Stenosis After Unilateral Transforaminal Lumbar Interbody Fusion vol.133, pp.None, 2020, https://doi.org/10.1016/j.wneu.2019.09.048
  5. A Transforaminal Endoscopic Surgical Technique for Treating Lumbar Disc Herniation in the Setting of Spina Bifida vol.2020, pp.None, 2020, https://doi.org/10.1155/2020/1076847
  6. CHANGES IN THE LUMBAR VERTEBRAL SEGMENT RELATED TO THE CAGE POSITION IN TLIF TECHNIQUE vol.28, pp.2, 2020, https://doi.org/10.1590/1413-785220202802224215
  7. Contralateral radiculopathy after unilateral transforaminal lumbar interbody fusion: causes and prevention vol.49, pp.8, 2015, https://doi.org/10.1177/03000605211037475