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Change of Lumbar Ligamentum Flavum after Indirect Decompression Using Anterior Lumbar Interbody Fusion
| Content Provider | Semantic Scholar |
|---|---|
| Author | Ohtori, Seiji Orita, Sumihisa Yamauchi, Kazuyo Eguchi, Yawara Aoki, Yoshitaka Nakamura, Junichi Miyagi, Masayuki Suzuki, Miyako Kubota, Gou Inage, Kazuhide Sainoh, Takeshi Sato, Jun Fujimoto, Kazuki Shiga, Yasuhiro Abe, Koki Kanamoto, Hiroto Inoue, Gen Takahashi, Kazuhisa Furuya, Takeo Koda, Masao |
| Copyright Year | 2017 |
| 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. |
| Starting Page | 105 |
| Ending Page | 112 |
| Page Count | 8 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 28243378v1 |
| Alternate Webpage(s) | https://doi.org/10.4184/asj.2017.11.1.105 |
| DOI | 10.4184/asj.2017.11.1.105 |
| Journal | Asian spine journal |
| Volume Number | 11 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Bone Marrow Diseases Bone Tissue Bone structure of ilium Bone structure of lumbar vertebra Cross-Sectional Anatomy Diameter (qualifier value) Fusion procedure Greater Iliac crest structure Large Lumbar Region Pain relief Patients Sensorineural Hearing Loss (disorder) Spinal Canal Spinal Cord Neoplasms Spondylolisthesis Structure of ligamentum flavum spindle assembly checkpoint square millimeter (qualifier value) |
| Content Type | Text |
| Resource Type | Article |
