Clinical Outcomes of Prone Transpsoas Lumbar Interbody Fusion: A 1-Year Follow-Up.

IF 1.7 Q2 SURGERY International Journal of Spine Surgery Pub Date : 2024-09-12 DOI:10.14444/8625

Hardeep Singh, Ian Wellington, Francine Zeng, Christopher Antonacci, Michael Mancini, Mirghani Mohamed, Joellen Broska, Scott Mallozzi, Isaac Moss

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引用次数: 0

Abstract

Background: Lateral lumbar interbody fusion (LLIF) is commonly used to address various lumbar pathologies. LLIF using the prone transpsoas (PTP) approach has several potential advantages, allowing simultaneous access to the anterior and posterior columns of the spine. The aim of this study was to report the 1-year outcomes of LLIF via PTP.

Methods: This is a retrospective review of 97 consecutive patients who underwent LLIF via PTP. Radiographic parameters, including lumbar-lordosis, segmental-lordosis, anterior disc height, and posterior disc height, were measured on preoperative, initial-postoperative, and 1-year postoperative imaging. Patient-reported outcomes measures, including Oswestry Disability Index, visual analog scale (VAS), pain EQ5D, and postoperative complications, were reviewed.

Results: Ninety-seven consecutive patients underwent 161 levels of LLIF. Fifty-seven percent underwent 1-level LLIF, 30% 2-level LLIF, 6% 3-level LLIF, and 7% 4-level LLIF. The most common level was L4 to L5 (35%), followed by L3 to L4 (33%), L2 to L3 (21%), and L1 to L2 (11%). Significant improvements were noted at initial and 1-year postoperative periods in lumbar-lordosis (2° ± 10°, P = 0.049; 3° ± 9°, P = 0.005), segmental-lordosis (6° ± 5°, P < 0.001; 5° ± 5°, P < 0.001), anterior disc height (8 mm ± 4 mm, P < 0.001; 7 mm ± 4 mm, P < 0.001), and posterior disc height (3 mm ± 2 mm, P < 0.001; 3 mm ± 2 mm, P < 0.001). Significant improvements were seen in Oswestry Disability Index at 6 weeks (P = 0.002), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively; pain EQ5D at 6 weeks (P < 0.001), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively; and leg and back visual analog scale at 2 weeks (P < 0.001), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively. The average length of stay was 2.5 days, and the most common complications were ipsilateral hip flexor pain (46%), weakness (59%), and contralateral hip flexor pain (29%).

Conclusion: PTP is a novel way of performing LLIF. These 1-year data support that PTP is an effective, safe, and viable approach with similar patient-reported outcome measures and complications profiles as LLIF performed in the lateral decubitus position.

Level of evidence: 4:

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俯卧位经腰椎椎间融合术的临床疗效：一年随访

背景：侧腰椎椎体间融合术（LLIF）常用于治疗各种腰椎疾病。采用俯卧位转体肌（PTP）方法进行 LLIF 有几个潜在的优势，可以同时进入脊柱的前柱和后柱。本研究旨在报告通过 PTP 进行 LLIF 的 1 年疗效：这是一项回顾性研究，共收集了 97 例通过 PTP 进行 LLIF 的连续患者的资料。在术前、术后初期和术后 1 年的影像学检查中测量了包括腰椎畸形、节段性畸形、椎间盘前部高度和椎间盘后部高度在内的影像学参数。患者报告的结果指标包括 Oswestry 失能指数、视觉模拟量表（VAS）、疼痛 EQ5D 和术后并发症：结果：97名患者连续接受了161级LLIF手术。57%的患者接受了1级LLIF，30%接受了2级LLIF，6%接受了3级LLIF，7%接受了4级LLIF。最常见的水平是 L4 到 L5（35%），其次是 L3 到 L4（33%）、L2 到 L3（21%）和 L1 到 L2（11%）。腰椎畸形（2° ± 10°，P = 0.049；3° ± 9°，P = 0.005）、节段性腰椎畸形（6° ± 5°，P < 0.001；5° ± 5°，P < 0.001）、椎间盘前部高度（8 mm ± 4 mm，P < 0.001；7 mm ± 4 mm，P < 0.001）和椎间盘后部高度（3 mm ± 2 mm，P < 0.001；3 mm ± 2 mm，P < 0.001）。术后6周（P = 0.002）、6个月（P < 0.001）和1年（P < 0.001）的Oswestry残疾指数；术后6周（P < 0.001）、6个月（P < 0.001）和1年（P < 0.001）的疼痛EQ5D；术后2周（P < 0.001）、6个月（P < 0.001）和1年（P < 0.001）的腿部和背部视觉模拟量表均有显著改善。平均住院时间为2.5天，最常见的并发症是同侧髋屈肌疼痛（46%）、无力（59%）和对侧髋屈肌疼痛（29%）：结论：PTP 是进行 LLIF 的一种新方法。这些为期一年的数据支持 PTP 是一种有效、安全、可行的方法，其患者报告的结果指标和并发症情况与侧卧位进行的 LLIF 相似：4:

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来源期刊

International Journal of Spine Surgery Medicine-Surgery

CiteScore

3.10

自引率

0.00%

发文量

162

期刊介绍： The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.