Comprehensive Assessment of Indirect Decompression Through Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spinal Stenosis: A Japanese Orthopedic Association Back Pain Evaluation Questionnaire-Based Analysis

Akihiko Hiyama; Daisuke Sakai; Hiroyuki Katoh; Masato Sato; Masahiko Watanabe

doi:10.1177/21925682231204254

Comprehensive Assessment of Indirect Decompression Through Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spinal Stenosis: A Japanese Orthopedic Association Back Pain Evaluation Questionnaire-Based Analysis

Global Spine J. 2023 Sep 26:21925682231204254. doi: 10.1177/21925682231204254. Online ahead of print.

Authors

Akihiko Hiyama¹, Daisuke Sakai¹, Hiroyuki Katoh¹, Masato Sato¹, Masahiko Watanabe¹

Affiliation

¹ Department of Orthopaedic Surgery, Tokai University School of Medicine, Japan.

PMID: 37750358
DOI: 10.1177/21925682231204254

Abstract

Study design: A retrospective study.

Objective: This study aimed to comprehensively evaluate the clinical outcomes of lateral lumbar interbody fusion (LLIF) as an indirect decompression technique for degenerative spondylolisthesis (DS) and concomitant degenerative lumbar spinal stenosis (DLSS) patients. We utilized the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) to assess treatment success and its impact on patient's quality of life (QOL).

Methods: We included 124 patients who underwent LLIF. Pre- and postoperative JOABPEQ evaluations indicated treatment success. Subgroup analysis categorized patients' perceptions of surgery as beneficial or non-beneficial.

Results: 89% of patients (110/124) reported satisfaction with LLIF. Lateral lumbar interbody fusion achieved successful indirect decompression, increasing canal diameter and central canal area. Significant improvements occurred across all JOABPEQ domains, notably for low back pain, lumbar function, walking ability, social life function, and mental health. Patients who perceived the surgery as beneficial experienced fewer postoperative complications, lower numeric rating scale scores for pain relief, and greater functional outcome improvements compared to non-beneficial patients.

Conclusions: Our findings highlight the utility of JOABPEQ as a valuable and sensitive tool for assessing treatment effectiveness and patient-reported outcomes in DS and concomitant DLSS patients. Patients undergoing LLIF. The results affirm the favorable outcomes of LLIF as a surgical option for DLSS patients and emphasize the importance of considering patient perspectives when evaluating overall treatment success. The study provides valuable insights into the impact of indirect decompression on patients' QOL, supporting the effectiveness of LLIF as a minimally invasive technique for DLSS and DS management.

Keywords: Japanese orthopedic association back pain evaluation questionnaire; degenerative lumbar spinal stenosis; indirect decompression; lateral lumbar interbody fusion; patient-reported outcome measures.