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KMID : 1189320230170020373
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Asian Spine Journal
2023 Volume.17 No. 2 p.373 ~ p.381
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Prospective Cohort Study with a 2-Year Follow-up of Clinical Results, Fusion Rate, and Muscle Bulk for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion
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Pang Hung Wu
Kim Hyeun-Sung
An Jin-Woo
Kim Myeong-Hun
Lee In-Kyung
Park Jong-Seon
Lee Jun-Hyoung
Kang Sang-Soo
Lee Jeong-Shik
Yi Yeon-Jin
Lee Jun-Hyung
Park Jun-Hwan
Lim Jae-Hyeon
Jang Il-Tae
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Abstract
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Study Design: Retrospective cohort study.
Purpose: Postoperative evaluation of the cross-sectional area of paraspinal muscle and clinical findings in patients who had interlaminar route uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion (EPTLIF) after 2 years.
Overview of Literature: There are limited short-term follow-up studies on efficacy, safety, and physiological changes with a 2-year follow-up. There is no study on paraspinal muscle cross-sectional area change in patients who had undergone uniportal EPTLIF.
Methods: We evaluated patients who underwent EPTLIF with a minimum 24-month follow-up. Clinical parameters of the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were measured at the preoperative, 1-week postoperative mark, postoperative 3-month mark, and final follow-up. Preoperative and 1-year postoperative magnetic resonance imaging measurement of preoperative and postoperative Kjaer grade, right and left psoas muscle mass area, and right and left paraspinal muscle mass area was performed.
Results: EPTLIF with a minimum 24-month follow-up of 35 levels was included. The complication rate was 6%, and the mean Bridwell’s fusion grade was 1.37 (1?2). There was statistically significant improvement at 1 week, 3 months, and 2 years in VAS (4.11±1.23, 4.94±1.30, and 5.46±1.29) and in ODI (40.34±10.06, 46.69±9.14, and 49.63±8.68), respectively (p <0.05). Successful operation rate with excellent and good MacNab’s criteria at 2 years was 97%. There was an increment of statistically significant bilateral psoas muscle cross-sectional area, right side (70.03±149.1 mm²) and left side (67.59±113.2 mm²) (p <0.05).
Conclusions: Uniportal EPTLIF achieved good fusion and improved clinical outcomes with favorable paraspinal musculature bulk at the 2-year follow-up.
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KEYWORD
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Spine, Spine osteoarthritis, Surgical endoscopy, Minimally invasive surgical procedures, Spinal fusion, Spondylolisthesis
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