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Change of Lumbar Ligamentum Flavum after Indirect Decompression Using Anterior Lumbar Interbody Fusion
Asian Spine Journal ; : 105-112, 2017.
Artículo en Inglés | WPRIM | ID: wpr-170769
ABSTRACT
STUDY

DESIGN:

Retrospective case series.

PURPOSE:

The purpose of this study was to examine changes in the ligamentum flavum thickness and remodeling of the spinal canal after anterior fusion during a 10-year follow-up. OVERVIEW OF LITERATURE Extreme lateral interbody fusion provides minimally invasive treatment of the lumbar spine; this anterior fusion without direct posterior decompression, so-called indirect decompression, can achieve pain relief. Anterior fusion may restore disc height, stretch the flexure of the ligamentum flavum, and increase the spinal canal diameter. However, changes in the ligamentum flavum thickness and remodeling of the spinal canal after anterior fusion during a long follow-up have not yet been reported.

METHODS:

We evaluated 10 patients with L4 spondylolisthesis who underwent stand-alone anterior interbody fusion using the iliac crest bone. Magnetic resonance imaging was performed 10 years after surgery. The cross-sectional area (CSA) of the dural sac and the ligamentum flavum at L1–2 to L5–S1 was calculated using a Picture Archiving and Communication System.

RESULTS:

Spinal fusion with correction loss (average, 4.75 mm anterior slip) was achieved in all patients 10 years postsurgery. The average CSAs of the dural sac and the ligamentum flavum at L1–2 to L5–S1 were 150 mm² and 78 mm², respectively. The average CSA of the ligamentum flavum at L4–5 (30 mm²) (fusion level) was significantly less than that at L1–2 to L3–4 or L5–S1. Although patients had an average anterior slip of 4.75 mm, the average CSA of the dural sac at L4–5 was significantly larger than at the other levels.

CONCLUSIONS:

Spinal stability induced a lumbar ligamentum flavum change and a sustained remodeling of the spinal canal, which may explain the long-term pain relief after indirect decompression fusion surgery.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Canal Medular / Fusión Vertebral / Columna Vertebral / Espondilolistesis / Imagen por Resonancia Magnética / Estudios Retrospectivos / Estudios de Seguimiento / Ligamento Amarillo / Descompresión Tipo de estudio: Estudio observacional / Estudio pronóstico Límite: Humanos Idioma: Inglés Revista: Asian Spine Journal Año: 2017 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Canal Medular / Fusión Vertebral / Columna Vertebral / Espondilolistesis / Imagen por Resonancia Magnética / Estudios Retrospectivos / Estudios de Seguimiento / Ligamento Amarillo / Descompresión Tipo de estudio: Estudio observacional / Estudio pronóstico Límite: Humanos Idioma: Inglés Revista: Asian Spine Journal Año: 2017 Tipo del documento: Artículo