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Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion
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 retrospecti...
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Published in: | Journal of Korean Neurosurgical Society 2015, 58(4), , pp.350-356 |
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creator | Jang, Kyoung-Min Park, Seung-Won Kim, Young-Baeg Park, Yong-Sook Nam, Taek-Kyun Lee, Young-Seok |
description | 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 |
doi_str_mv | 10.3340/jkns.2015.58.4.350 |
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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<0.05).
The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.</description><identifier>ISSN: 2005-3711</identifier><identifier>EISSN: 1598-7876</identifier><identifier>DOI: 10.3340/jkns.2015.58.4.350</identifier><identifier>PMID: 26587189</identifier><language>eng</language><publisher>Korea (South): The Korean Neurosurgical Society</publisher><subject>Clinical ; 신경외과학</subject><ispartof>대한신경외과학회지, 2015, 58(4), , pp.350-356</ispartof><rights>Copyright © 2015 The Korean Neurosurgical Society 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-ab1cf722605b14ebc9ed8ecab23e7f633e51b0bd7580f815dd614c2142d2cee23</citedby><cites>FETCH-LOGICAL-c465t-ab1cf722605b14ebc9ed8ecab23e7f633e51b0bd7580f815dd614c2142d2cee23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651996/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651996/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26587189$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002044430$$DAccess content in National Research Foundation of Korea (NRF)$$Hfree_for_read</backlink></links><search><creatorcontrib>Jang, Kyoung-Min</creatorcontrib><creatorcontrib>Park, Seung-Won</creatorcontrib><creatorcontrib>Kim, Young-Baeg</creatorcontrib><creatorcontrib>Park, Yong-Sook</creatorcontrib><creatorcontrib>Nam, Taek-Kyun</creatorcontrib><creatorcontrib>Lee, Young-Seok</creatorcontrib><title>Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion</title><title>Journal of Korean Neurosurgical Society</title><addtitle>J Korean Neurosurg Soc</addtitle><description>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<0.05).
The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.</description><subject>Clinical</subject><subject>신경외과학</subject><issn>2005-3711</issn><issn>1598-7876</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNpVUU1v0zAYthCIlcEf4IByQeKS4G87F6Sq2qBQadLUHThZtuMwr4ld7ASp_x63ZQMufmU_H35ePQC8RbAhhMKPD7uQGwwRa5hsaEMYfAYWiLWyFlLw52CBIWQ1EQhdgFc5P0DICZTsJbjAnEmBZLsA35d2nly1imFKetCTK2d1qztv5yHu9XR_qHRfXqu74B_hbdIh9zHp0Ydy3cyj0alah4Ka2B2q6zn7GF6DF70esnvzZ16Cu-ur7epLvbn5vF4tN7WlnE21Nsj2AmMOmUHUGdu6TjqrDSZO9JwQx5CBphNMwl4i1nUcUYsRxR22zmFyCT6cfUPq1c56FbU_zR9R7ZJa3m7XChOCMS3UT2fqfjaj66w7La32yY86HU7C_5Hg74vNL1WSorblxeD92WDn8-RV6PKgvi6_3RxLgAgzjgRluP2baZ_iz9nlSY0-WzcMOrg4Z1VoLSuGTBQqPlNtijkn1z_FQVAda1bHmtXxB8WkoqrUXETv_l3kSfLYK_kN9Umkqw</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Jang, Kyoung-Min</creator><creator>Park, Seung-Won</creator><creator>Kim, Young-Baeg</creator><creator>Park, Yong-Sook</creator><creator>Nam, Taek-Kyun</creator><creator>Lee, Young-Seok</creator><general>The Korean Neurosurgical Society</general><general>대한신경외과학회</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>JDI</scope><scope>5PM</scope><scope>ACYCR</scope></search><sort><creationdate>20151001</creationdate><title>Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion</title><author>Jang, Kyoung-Min ; Park, Seung-Won ; Kim, Young-Baeg ; Park, Yong-Sook ; Nam, Taek-Kyun ; Lee, Young-Seok</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-ab1cf722605b14ebc9ed8ecab23e7f633e51b0bd7580f815dd614c2142d2cee23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Clinical</topic><topic>신경외과학</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jang, Kyoung-Min</creatorcontrib><creatorcontrib>Park, Seung-Won</creatorcontrib><creatorcontrib>Kim, Young-Baeg</creatorcontrib><creatorcontrib>Park, Yong-Sook</creatorcontrib><creatorcontrib>Nam, Taek-Kyun</creatorcontrib><creatorcontrib>Lee, Young-Seok</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>KoreaScience</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Korean Citation Index</collection><jtitle>Journal of Korean Neurosurgical Society</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jang, Kyoung-Min</au><au>Park, Seung-Won</au><au>Kim, Young-Baeg</au><au>Park, Yong-Sook</au><au>Nam, Taek-Kyun</au><au>Lee, Young-Seok</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion</atitle><jtitle>Journal of Korean Neurosurgical Society</jtitle><addtitle>J Korean Neurosurg Soc</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>58</volume><issue>4</issue><spage>350</spage><epage>356</epage><pages>350-356</pages><issn>2005-3711</issn><eissn>1598-7876</eissn><abstract>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<0.05).
The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed.</abstract><cop>Korea (South)</cop><pub>The Korean Neurosurgical Society</pub><pmid>26587189</pmid><doi>10.3340/jkns.2015.58.4.350</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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title | Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion |
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