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KMID : 1148120210110020045
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Journal of Advanced Spine Surgery
2021 Volume.11 No. 2 p.45 ~ p.52
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Microscope Assisted Direct Decompression Combined with Oblique Lumbar Interbody Fusion or Anterior Lumbar Interbody Fusion
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Son Eun-Seok
Koo Tae-Won
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Abstract
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Background: Oblique and anterior lumbar interbody fusion have been widely performed in the lumbar spinal disease but we cannot get a direct decompression effect with these procedure.
Objective: The purpose of this study is to report clinical and imaging outcomes of microscope assisted direct decompression combined with oblique lumbar interbody fusion (OLIF) or anterior lumbar interbody fusion (ALIF).
Methods: Twelve patients who received microscope assisted direct decompression during OLIF or ALIF for lumbar spinal stenosis were enrolled. The OLIF was performed for the lesion upper than the L4-5 or in the case of multisegmental disease. The ALIF was performed for the lesion at the L5-S1. After anterior-approaching surgery, percutaneous fixation of pedicle screw was performed and we did not perform an additional decompression posteriorly in all cases. For the clinical outcomes, we evaluated short form 36 (SF-36), Oswestry disability index (ODI) score and visual analog scale (VAS) pain score. For the imaging outcomes, we obtained postoperative lumbar magnetic resonance imaging (MRI).
Results: The OLIF was performed for 9 patients and the ALIF was performed for 3 patients. In the clinical outcomes, SF-36 was improved from 25.40 to 69.83 and ODI score was also improved from 69.83 to 16.50. VAS pain score of back was improved from 4.3 to 1.6 and VAS pain score of leg was improved from 7.5 to 2.2. In the imaging outcomes, all patients had severe stenosis before surgery. After surgery the severity of the stenosis was reduced to mild state in 9 cases and moderate state in 3 cases postoperatively.
Conclusions: We could obtain the good clinical outcomes and effective decompression through microscope assisted direct decompression during OLIF or ALIF.
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KEYWORD
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Lumbar spine, Stenosis, Direct decompression, Oblique lumbar interbody fusion, Anterior lumbar interbody fusion
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