284 - Lateral Interbody Fusion for the Treatment of Discogenic Low Back Pain...

#284 Lateral Interbody Fusion for the Treatment of Discogenic Low Back Pain

MIS Techniques and Outcomes

Poster Presented by: L. Pimenta

Author(s):

L. Pimenta (1), (2)
R. Jensen (1)
L. Marchi (1)
L. Oliveira (1)
C. Castro (1)
E. Coutinho (1)
T. Coutinho (1)
R. Amaral (1)

(1) Instituto de Patologia da Coluna, Sao Paulo, Brazil
(2) UCSD, Neurosurgery, San Diego, CA, USA

Abstract

Background Context: Lumbar low back pain is one of the most common causes of spine problems along aging. Treatment choice is still very controversial and reimbursement remains a huge barrier of surgical procedures. We have evaluated a surgical treatment of lumbar discogenic pain with interbody fusion via a minimally invasive lateral access.

Patient Sample: Prospective, non-randomized single-center study with twenty-two patients (mean age 57.6 years, range 32-85; mean BMI 28.9, SD 7.9; 50% female) and 28 lumbar spine levels . Clinical evaluations included a physical exam for lower extremity motor and sensory function, and self-assessed questionnaires using the Oswestry disability index (ODI) and visual analogue scale for back and leg symptoms at preoperative visit and after 1 and 6 weeks, 3, 6, 12 and 24 months. Minimum follow-up was 24 months.

Methods: Discectomy and interbody grafting were performed via retroperitoneal lateral transpsoas. Clinical and radiological parameters were analyzed at the pre-op and post-op periods up to 24 months.

Results: Mean surgical duration was 72.1 minutes. Three patients had additional percutaneous pedicle screw instrumentation. Four (14.3%) stand-alone levels experienced cage subsidence. Clinical outcomes (VAS and ODI) were seen to improve in a fast and long lasting pattern. Index level lordosis was significantly augmented and fusion rate reached 92.9% at the final evaluation.

Conclusions: Isolated axial low back pain arising from degenerative disc disease was treated surgically with great success in this case series. The minimally invasive lateral interbody fusion was seen to be safe and effective for patients with persistent discogenic symptoms.