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2013년 11월 4일 월요일

An Institutional Six-year Trend Analysis of the Neurological Outcome After Lateral Lumbar Interbody Fusion: A 6-Year Trend Analysis of a Single Institution.

Brief review


*Title: An Institutional Six-year Trend Analysis of the Neurological Outcome After Lateral Lumbar Interbody Fusion: A 6-Year Trend Analysis of a Single Institution.
측부요추체 유합술 후의 신경학적 결과의 6년간 기관 동향 분석: 단일 기관의 6년간의 동향 분석

*Author: Alexander Aichmair, Marios G. Lykissas, Federico P. Girardi, Andrew A. Sama, Darren R. Lebl, Fadi Taher, Frank P. Cammisa, and Alexander P. Hughes




STUDY DESIGN
Retrospective case series.


OBJECTIVE
To evaluate the proportional trend of neurological deficits after lateral lumbar interbody fusion (LLIF) at a single institution.


SUMMARY OF BACKGROUND DATA
Lumbar nerve roots are prone to iatrogenic damage during the transpsoas approach in LLIF, and postoperative neurological sequelae remain a major concern.


METHODS
Subject number: 451 patients (undergone LLIF)

Period: 2006.03~2012.04

-The electronic medical records and office notes were retrospectively reviewed.
(For reports on postoperative neurological deficits)


RESULTS
>>The number of included patients who underwent LLIF
(mean follow up period: 15.4±9.2 months)
-2006~2008: 47 patients (group A)
-2009~2010: 155 patients (group B)
-2011~2012: 91 patients (group C)


>>Indicate a decreasing proportional trend or postoperative sensory deficits (SDs), motor deficits (MDs), and anterior thigh pain (TP).
-SDs- immediate postoperative: statistically significant in decreasing proportion (P=0.018)
         - last follow-up: close to statistically significant in decreasing proportion (P=0.126)

-TP -immediate postoperative: close to statistically significant in decreasing proportion 
         (P = 0.098)
  -last follow-up: close to statistically significant in decreasing proportion (P = 0.136)


CONCLUSION
The present data indicate a decreasing proportional trend for SDs, MDs, anterior TP
(Institutional learning curve during a 6-year time period of performing LLIF)