Abstract
Introduction
Spinal deformity of the adult lumbar spine may occur de novo because of the degenerative disease or following decompressive surgery. Asymmetric loss of disc height may lead to unilateral vertical foraminal stenosis and radiculopathy.
Aims/Objectives: This study aimed to investigate whether restoration of foraminal height at the symptomatic level using single-level extreme lateral interbody fusion (ELIF) may alleviate unilateral radicular pain.
Methods
In a retrospective cohort study, patients with single-level unilateral vertical foraminal stenosis (foraminal height < 15 mm) and corresponding unilateral radicular pain who underwent ELIF were included. Demographic and perioperative data were collected. Functional data (Visual Analogue Scale [VAS] for buttock, leg and back, as well as Oswestry Disability Index [ODI]) and radiographic measurements (bilateral foraminal height, disc height, segmental coronal Cobb angle, and regional lumbar lordosis) were collected preoperatively, postoperatively, and at the last follow-up.
Results
A total of 23 patients with a mean age of 66 years were included. The foraminal height of stenotic side was significantly increased by ELIF from the preoperative value of 11.0 to 18.1 mm postoperatively (p < 0.001). The increase was durable at last follow-up of 11 ± 3.7 (SE) months (17.1 mm; p < 0.001). Preoperative VAS buttock and leg on the stenotic side, VAS back, and the ODI (7.3, 7.2, 6.5 and 48.0, respectively) were significantly improved postoperatively (1.5, 2.3, 3.3 and 25.4, respectively) and at the last follow-up (to 0.7, 1.1, 3.3 and 23.0). The postoperative FH on the stenotic side showed correlation with the VAS buttock and VAS leg on the stenotic side. In addition, at the last follow-up, FH on the stenotic side showed correlation with VAS leg on the stenotic side.
Conclusion
Single-level ELIF is an effective procedure for treatment of symptomatic unilateral vertical foraminal stenosis.