Short-Term Clinical and Radiographic Evaluation of Patients Treated With Expandable and Static Interbody Spacers Following Lumbar Lateral Interbody Fusion

Yawara Eguchi; Noritaka Suzuki; Sumihisa Orita; Kazuhide Inage; Miyako Narita; Yasuhiro Shiga; Masahiro Inoue; Noriyasu Toshi; Soichiro Tokeshi; Kohei Okuyama; Shuhei Ohyama; Satoshi Maki; Yasuchika Aoki; Junichi Nakamura; Shigeo Hagiwara; Yuya Kawarai; Tsutomu Akazawa; Masao Koda; Hiroshi Takahashi; Seiji Ohtori

doi:10.1016/j.wneu.2024.03.039

Short-Term Clinical and Radiographic Evaluation of Patients Treated With Expandable and Static Interbody Spacers Following Lumbar Lateral Interbody Fusion

World Neurosurg. 2024 Mar 15:S1878-8750(24)00424-8. doi: 10.1016/j.wneu.2024.03.039. Online ahead of print.

Authors

Yawara Eguchi¹, Noritaka Suzuki², Sumihisa Orita³, Kazuhide Inage², Miyako Narita², Yasuhiro Shiga², Masahiro Inoue², Noriyasu Toshi², Soichiro Tokeshi², Kohei Okuyama², Shuhei Ohyama², Satoshi Maki², Yasuchika Aoki⁴, Junichi Nakamura², Shigeo Hagiwara², Yuya Kawarai², Tsutomu Akazawa⁵, Masao Koda⁶, Hiroshi Takahashi⁶, Seiji Ohtori²

Affiliations

¹ Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan; Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido, Chiba, Japan. Electronic address: yawara_eguchi@yahoo.co.jp.
² Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
³ Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan; Center for Frontier Medical Engineering, Chiba University, Chiba, Japan.
⁴ Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan.
⁵ Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
⁶ Department of Orthopedic Surgery, University of Tsukuba, Tsukuba-City, Ibaraki, Japan.

PMID: 38493893
DOI: 10.1016/j.wneu.2024.03.039

Abstract

Objective: The goal of this study was to evaluate, using computed tomography (CT) and magnetic resonance imaging (MRI), patients who underwent oblique lateral interbody fusion (OLIF) using either expandable or static interbody spacers.

Methods: Thirty-five patients with degenerative disc disease were surgically treated with one-level OLIF and were followed up for more than 6 months. The Static group consisted of 22 patients, and 13 patients were in the Expandable group. Intraoperative findings included operative time (min), blood loss (ml), and cage size. Low back pain, leg pain, and leg numbness were measured using the Japanese Orthopedic Association score, visual analogue score, and the Roland-Morris Disability Questionnaire. Radiologic evaluation using computed tomography (CT) and magnetic resonance imaging (MRI) allowed measurement of cage subsidence, cross-sectional area (CSA) of the dural sac, disc height, segmental lordosis, foraminal height, and foraminal CSA preoperatively and 6 months postoperatively.

Results: The Expandable group had significantly larger cage height and lordosis than the Static group (P < 0.05). The Expandable group also had greater dural sac area expansion and enlargement of the intervertebral foramen, as well as better correction of vertebral body slip (P < 0.05). Cage subsidence was significantly lower in the Expandable group (P < 0.05). JOA and VAS scores for leg numbness were significantly better in the Expandable group (P < 0.05).

Conclusions: Compared with static spacers, expandable spacers significantly enlarged the dural sac area, corrected vertebral body slippage, expanded the intervertebral foramen, and achieved good indirect decompression while reducing cage subsidence, resulting in improvement in clinical symptoms.

Keywords: Expandable interbody spacers; Indirect decompression; Oblique lumbar interbody fusion.