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

*Bibliography: Spine (Phila Pa 1976). 2013Nov 1;38(23):E1483-90.

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)