Is there any relation between the amount of curve correction and postoperative neurological deficit or pain in patients undergoing stand-alone lateral lumbar interbody fusion?

STUDY DESIGN

Retrospective analysis of 73 standalone lateral lumbar interbody fusion (LLIF) procedures to identify any association between the amount of coronal curve correction and lumbosacral plexus injuries and/or postoperative pain.

OBJECTIVE

To address if there is any association between the amount of correction in both the coronal and sagittal planes and the development of postoperative neurological deficit and/or anterior thigh/groin pain.

SUMMARY OF BACKGROUND DATA

LLIF is a powerful tool for the restoration of spinal alignment including correction of small degenerative curves of the lumbar spine and increase of lumbar lordosis. Concerns remain about its safety regarding injuries of the lumbosacral plexus, which occur with a prevalence ranging from 0.7% to 23%.

METHODS

The medical records and spinal radiographs of patients undergoing standalone LLIF for symptomatic degenerative scoliosis of the lumbar spine were retrospectively reviewed during a 6-year period.

RESULTS

Thirty patients (73 levels) met the inclusion criteria and were followed for a mean of 21 months (range, 9-39 mo). Average age at the time of surgery was 67 years (range, 50-78 yr). Immediately after surgery, a motor deficit was recorded in 6 patients and a sensory deficit in 17 patients. Statistical analysis did not reveal any significant association between the amount of coronal curve correction, restoration of lumbar lordosis or increase in lumbar spine height, and the development of postoperative motor or sensory deficits. Seventeen patients complained of anterior thigh/groin pain immediately postoperative. A statistically significant association was identified between postoperative anterior thigh/groin pain and the magnitude of curve correction (P = 0.005), as well as the increase in lumbar lordosis (P = 0.040).

CONCLUSION

There is a strong association between the development of postoperative anterior thigh/groin pain and the amount of coronal curve correction, as well as the increase in lumbar lordosis.

LEVEL OF EVIDENCE