Luca Proietti1,2, Andrea Perna1,2, Luca Ricciardi3,4, Caterina Fumo1,2, Domenico Alessandro Santagada1,2, Ilaria Giannelli1,2, Francesco Ciro Tamburrelli1,2, Antonio Leone1,5. 1. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 2. Istituto di Ortopedia e Traumatologia, Università Cattolica del Sacro Cuore, Rome, Italy. 3. UO di Neurochirurgia, Pia Fondazione di Culto e Religione Cardinal G. Panico, Via Pio X, 4, 73039, Tricase, LE, Italy. ricciardi.lu@gmail.com. 4. UO di Neurochirurgia, Azienda Ospedaliera Sant'Andrea, Facoltà di Medicina e Psicologia, Sapienza, Rome, Italy. ricciardi.lu@gmail.com. 5. Dipartimento di Scienze Radiologiche, Università Cattolica del Sacro Cuore, Rome, Italy.
Abstract
INTRODUCTION: There is no consensus on how to evaluate segmental fusion after lateral lumbar interbody fusion (LLIF). Bone bridges (BB) between two contiguous vertebra are reported as pathognomonic criteria for anterior fusion. However, to the best of our knowledge, there are no radiological investigations on zygapophyseal joints (ZJ) status after LLIF. The aim of this radiological study was to investigate the different fusion patterns after LLIF. MATERIALS AND METHODS: This is a retrospective single-centre radiological study. Patients who underwent LLIF and posterior percutaneous screw fixation for degenerative spondylolisthesis, on a single lumbar level, were considered for eligibility. Complete radiological data and a minimum follow-up of 1 year were the inclusion criteria. Intervertebral BB were investigated for evaluating anterior fusion and ZJ ankylotic degeneration was evaluated according Pathria et al., as a matter of proof of posterior fusion and segmental immobilization. RESULTS: Seventy-four patients were finally included in the present study. Twelve months after surgery, intervertebral BB were recognized in 58 segments (78.3%), whereas ZJ Pathria grade was I in 8 (10.8%) patients, II in 15 (20.3%) and III in 51 (68.9%) that were considered posteriorly fused. The overlapping rate between anteriorly and posteriorly fused segments was 72.4% (42 segments), whereas 10 (13.5%) did not achieve any fusion, anterior or posterior, and 6 (8.1%) were posteriorly fused only. CONCLUSIONS: Our results seem to suggest that anterior fusion is not sufficient to achieve segmental immobilization. Further properly designed investigations are needed to investigate eventual clinical-radiological correlations.
INTRODUCTION: There is no consensus on how to evaluate segmental fusion after lateral lumbar interbody fusion (LLIF). Bone bridges (BB) between two contiguous vertebra are reported as pathognomonic criteria for anterior fusion. However, to the best of our knowledge, there are no radiological investigations on zygapophyseal joints (ZJ) status after LLIF. The aim of this radiological study was to investigate the different fusion patterns after LLIF. MATERIALS AND METHODS: This is a retrospective single-centre radiological study. Patients who underwent LLIF and posterior percutaneous screw fixation for degenerative spondylolisthesis, on a single lumbar level, were considered for eligibility. Complete radiological data and a minimum follow-up of 1 year were the inclusion criteria. Intervertebral BB were investigated for evaluating anterior fusion and ZJ ankylotic degeneration was evaluated according Pathria et al., as a matter of proof of posterior fusion and segmental immobilization. RESULTS: Seventy-four patients were finally included in the present study. Twelve months after surgery, intervertebral BB were recognized in 58 segments (78.3%), whereas ZJ Pathria grade was I in 8 (10.8%) patients, II in 15 (20.3%) and III in 51 (68.9%) that were considered posteriorly fused. The overlapping rate between anteriorly and posteriorly fused segments was 72.4% (42 segments), whereas 10 (13.5%) did not achieve any fusion, anterior or posterior, and 6 (8.1%) were posteriorly fused only. CONCLUSIONS: Our results seem to suggest that anterior fusion is not sufficient to achieve segmental immobilization. Further properly designed investigations are needed to investigate eventual clinical-radiological correlations.
Authors: Tanvir F Choudhri; Praveen V Mummaneni; Sanjay S Dhall; Jason C Eck; Michael W Groff; Zoher Ghogawala; William C Watters; Andrew T Dailey; Daniel K Resnick; Alok Sharan; Jeffrey C Wang; Michael G Kaiser Journal: J Neurosurg Spine Date: 2014-07
Authors: Amit K Sharma; Christopher K Kepler; Federico P Girardi; Frank P Cammisa; Russel C Huang; Andrew A Sama Journal: J Spinal Disord Tech Date: 2011-06