J Korean Soc Spine Surg.  2007 Dec;14(4):263-269.

The Comparison of Changes in the Dimensions of the Intervertebral Disc and Neural Foramen between Anterior Lumbar Interbody Fusion and Posterolateral Fusion in the Lumbar Spine

Affiliations
  • 1Department of Orthopedic Surgery, School of Medicine, Ajou University, Korea.
  • 2Department of Orthopedic Surgery, School of Medicine, Hallym University, Korea. yckim@hallym.or.kr

Abstract

STUDY DESIGN: A prospective radiologic assessment.
OBJECTIVES
To compare the changes of dimensions of the intervertebral disc and neural foramen between the anterior lumbar interbody fusion and the posterolateral fusion in the lumbar spine. SUMMARY OF LITERATURE REVIEW: There are few reports comparing an anterior lumbar interbody fusion with pedicle screw fixation and a posterolateral fusion with pedicle screw fixation.
MATERIALS AND METHODS
We studied 62 patients with degenerative lumbar diseases who underwent minimal anterior lumbar interbody fusion with pedicle screw fixation (group I, 40 patients) or who underwent posterolateral fusion with pedicle screw fixation (group II, 22 patients). We measured the height of disc and the height, width, and area of the neural foramen measured in 1-mm reconstructive sagittal images of computed tomography before and 6 months after the operation. The factors were independently measured by three different observers.
RESULTS
Disc height was increased by a mean of 39.1+/-3.28% in group I and 3.1+/-2.99% in group II. The height of the neural foramen was increased by a mean of 18.7+/-4.21% in I and 1.0+/-2.34% in II. The area of neural foramen was increased by a mean of 21.5+/-3.50% in I and -2.1+/-4.39% in II, with significant differences between groups in all parameters.
CONCLUSION
The minimal anterior lumbar interbody fusion with pedicle screw fixation was superior to posterolateral fusion with pedicle screw fixation for increasing disc height and the height and area of neural foramen.

Keyword

Neural foramen; Degenerative lumbar disease; Anterior interbody fusion; Posterolateral fusion; Pedicle screw fixation

MeSH Terms

Humans
Intervertebral Disc*
Prospective Studies
Spine*

Figure

  • Fig. 1. Schematic picture for CT measurement were done via sagittal reconstruction at the level of the mid pedicle on axial CT cut

  • Fig. 2. Diagram showing the measurements made on the discs and neuroforamina. a : anterior disc height, b : posterior disc height, c : neuroforminal height

  • Fig. 3. A 62-year-old woman with spinal stenosis on L4-5 that treated anterior interbody fusion with pedicle screw fixation. (A) Left side sagittal reconstruction image of preoperative CT scan (B) Left side sagittal reconstruction image of seven-month postoperative CT scan shows marked increase of the disc height, width and area of neural foramen.

  • Fig. 4. A 65-year-old woman with spinal stenosis on L4-5 that treated posterolateral fusion with pedicle screw fixation. (A) Left side sagittal reconstruction image of preoperative CT scan (B) Left side sagittal reconstruction image of six-month postoperative CT scan shows slight decrease of the posterior disc height, width and area of neural foramen.


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