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Radiological evaluation of fusion patterns after lateral lumbar interbody fusion: institutional case series

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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.

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Abbreviations

BB:

Bone bridges

CT:

Computer tomography

LL:

Lateral lumbar interbody fusion

PACS:

Picture archiving and communication system

PEEK:

PolyEther ether ketone

SD:

Standard deviation

ZJ:

Zygapophyseal joints

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Funding

No funding was received for this research.

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Author notes

  1. Luca Proietti, Andrea Perna and Luca Ricciardi have contributed equally to this paper.

Authors and Affiliations

  1. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Luca Proietti, Andrea Perna, Caterina Fumo, Domenico Alessandro Santagada, Ilaria Giannelli, Francesco Ciro Tamburrelli & Antonio Leone

  2. Istituto di Ortopedia e Traumatologia, Università Cattolica del Sacro Cuore, Rome, Italy

    Luca Proietti, Andrea Perna, Caterina Fumo, Domenico Alessandro Santagada, Ilaria Giannelli & Francesco Ciro Tamburrelli

  3. UO di Neurochirurgia, Pia Fondazione di Culto e Religione Cardinal G. Panico, Via Pio X, 4, 73039, Tricase, LE, Italy

    Luca Ricciardi

  4. UO di Neurochirurgia, Azienda Ospedaliera Sant’Andrea, Facoltà di Medicina e Psicologia, Sapienza, Rome, Italy

    Luca Ricciardi

  5. Dipartimento di Scienze Radiologiche, Università Cattolica del Sacro Cuore, Rome, Italy

    Antonio Leone

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  1. Luca Proietti
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Correspondence to Luca Ricciardi.

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Proietti, L., Perna, A., Ricciardi, L. et al. Radiological evaluation of fusion patterns after lateral lumbar interbody fusion: institutional case series. Radiol med 126, 250–257 (2021). https://doi.org/10.1007/s11547-020-01252-5

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