Salvage Strategy for Failed Spinal Fusion Surgery Using Lumbar Lateral Interbody Fusion technique: A Technical Note
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- Orita Sumihisa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Nakajima Takao
- Department of Orthopedic Surgery, Nippon Medical School, Chiba Hokusoh Hospital
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- Konno Kenta
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Inage Kazuhide
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Sainoh Takeshi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Fujimoto Kazuki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Sato Jun
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Shiga Yasuhiro
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Kanamoto Hirohito
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Abe Koki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Inoue Masahiro
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Kinoshita Hideyuki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Norimoto Masaki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Umimura Tomotaka
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Aoki Yasuchika
- Department of Orthopaedic Surgery, East Chiba Medical Center
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- Nakamura Junichi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Matsuura Yusuke
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Kubota Go
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Eguchi Yawara
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Hynes Richard A.
- Department of Orthopaedic Surgery, The Back Center Back Pain Spine Surgery, Melbourne
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- Akazawa Tsutomu
- Department of Orthopedic Surgery, St. Marianna University
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- Suzuki Miyako
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Takahashi Kazuhisa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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- Ohtori Seiji
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
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説明
<p>Introduction: Failed spinal fusion surgery sometimes requires salvage surgery when symptomatic, especially with postsurgical decrease in intervertebral disc height followed by foraminal stenosis. For such cases, an anterior approach to lumbar lateral interbody fusion (LLIF) provides safe, direct access to the pathological disc space and a potential improvement in the fusion rate. One LLIF approach, oblique lateral interbody fusion (OLIF), targets the oblique lateral window of the intervertebral discs to achieve successful lateral interbody fusion. The current technical note describes spinal revision surgery using the OLIF procedure.</p><p>Technical Note: The subjects were patients with leg pain and/or lower back pain derived from decreased intervertebral height followed by foraminal stenosis due to failed spinal fusion surgery. These patients underwent additional OLIF surgery and posterior fusion with no additional posterior direct decompression. Their outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scores at baseline and final follow-up. Bony union was also evaluated using computed tomography images at final follow-up.</p><p>Six subjects were evaluated, with two representative cases described in detail. Four patients had an adjacent segment disorder, and the other two patients had pseudarthrosis due to postoperative infection. The mean JOA score improved from 5.7 ± 5.4 to 21.2 ± 2.3, with a mean recovery rate of 65.0%. All cases showed intervertebral bony union.</p><p>Conclusions: We introduced a salvage strategy for failed posterior spine fusion surgery cases using the OLIF procedure. Patients effectively achieved recovered intervertebral and foraminal height with no additional posterior direct decompression.</p>
収録刊行物
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- Spine Surgery and Related Research
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Spine Surgery and Related Research 2 (1), 86-92, 2018
一般社団法人 日本脊椎脊髄病学会