Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion

• Published in: Journal of Korean Neurosurgical Society 2015, 58(4), , pp.350-356
• Main Authors: Jang, Kyoung-Min, Park, Seung-Won, Kim, Young-Baeg, Park, Yong-Sook, Nam, Taek-Kyun, Lee, Young-Seok
• Format: Article
• Language: English
• Subjects: Clinical; 신경외과학
• ISSN: 2005-3711; 1598-7876
• DOI: 10.3340/jkns.2015.58.4.350

Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p