Yingsakmongkol Wicharn, Wathanavasin Waranyoo, Jitpakdee Khanathip, Singhatanadgige Weerasak, Limthongkul Worawat, Kotheeranurak Vit
Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University (Thai Red Cross Society), Bangkok 10330, Thailand.
Department of Orthopaedics, Somdej Phra Phutthaloetla Hospital, Mae Klong, Samut Songkram 75000, Thailand.
Brain Sci. 2021 Mar 11;11(3):357. doi: 10.3390/brainsci11030357.
Extreme lateral interbody fusion (XLIF) is a minimally invasive surgery that accesses the lumbar spine through the psoas muscle. This study aimed to evaluate the correlation between the psoas major muscle volume and anterior thigh symptoms after XLIF.
Eighty-one patients (mean age 63 years) with degenerative spine diseases underwent XLIF (total = 94 levels). Thirty-eight patients were female (46.9%), and 24 patients (29.6%) had a history of lumbar surgery. Supplemental pedicle screws were used in 48 patients, and lateral plates were used in 28 patients. Neuromonitoring devices were used in all cases. The patients were classified into two groups (presence of thigh symptoms and no thigh symptoms after the surgery). The psoas major volumes were measured and calculated by CT (computed tomography) scan and compared between the two patient groups.
In the first 24 h after surgery, 32 patients (39.5%) had thigh symptoms (20 reported pain, 9 reported numbness, and 18 reported weakness). At one year postoperatively, only 3 of 32 patients (9.4%) had persistent symptoms.
As a final observation, no statistically significant difference in the mean psoas major volume was found between the group of patients with new postoperative anterior thigh symptoms and those with no thigh symptoms. Preoperative psoas major muscle volume seems not to correlate with postoperative anterior thigh symptoms after XLIF.
极外侧椎间融合术（XLIF）是一种通过腰大肌进入腰椎的微创手术。本研究旨在评估XLIF术后腰大肌体积与大腿前部症状之间的相关性。
81例（平均年龄63岁）患有退行性脊柱疾病的患者接受了XLIF手术（共94个节段）。38例为女性（46.9%），24例（29.6%）有腰椎手术史。48例患者使用了辅助椎弓根螺钉，28例患者使用了侧方钢板。所有病例均使用神经监测设备。将患者分为两组（术后出现大腿症状和未出现大腿症状）。通过CT（计算机断层扫描）扫描测量并计算腰大肌体积，并在两组患者之间进行比较。
术后24小时内，32例患者（39.5%）出现大腿症状（20例报告疼痛，9例报告麻木，18例报告无力）。术后一年，32例患者中只有3例（9.4%）有持续症状。
作为最终观察结果，术后出现大腿前部新症状的患者组与未出现大腿症状的患者组之间，腰大肌平均体积无统计学显著差异。术前腰大肌体积似乎与XLIF术后大腿前部症状无关。
