Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Lateral Lumbar Interbody Fusion and in Situ Screw Fixation for Rostral Adjacent Segment Stenosis of the Lumbar Spine

  • Choi, Young Hoon (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kwon, Shin Won (Department of Neurosurgery, Seoul National University Hospital) ;
  • Moon, Jung Hyeon (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kim, Chi Heon (Department of Neurosurgery, Seoul National University Hospital) ;
  • Chung, Chun Kee (Department of Neurosurgery, Seoul National University Hospital) ;
  • Park, Sung Bae (Department of Neurosurgery, Seoul National University Boramae Hospital) ;
  • Heo, Won (Department of Neurosurgery, Seoul National University Hospital)
  • Received : 2017.06.07
  • Accepted : 2017.08.21
  • Published : 2017.11.01
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Abstract

Objective : The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. Methods : The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Results : The median follow-up period was 13 months (range, 3-48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved (p<0.05). In the radiological analysis, both the segmental angle at the operated segment and anterior disc height were significantly increased. At 6 months postoperatively, solid bony fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. Conclusion : This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.

Keywords

References

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