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Decreasing thickness and remodeling of ligamentum flavum after oblique lumbar interbody fusion

  • Spinal Neuroradiology
  • Published:
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A Correction to this article was published on 07 July 2020

This article has been updated

Abstract

Purpose

Ligamentum flavum is one of the structures that could compress the spinal canal. Few studies have reported atrophy of ligamentum flavum after spinal fusion. The purpose of this study was to demonstrate the reduction of ligamentum flavum size after oblique lumbar interbody fusion (OLIF) using magnetic resonance imaging (MRI).

Method

Seventeen patients who underwent OLIF without direct decompression were included. The MRI was obtained at the preoperative period, immediate postoperative period, and the follow-up period. Disc height (DH) was measured in plain radiograph. MRI measurements were spinal canal cross-sectional area (SCSA), ligamentum flavum thickness (LFT), ligamentum flavum area (LFA), and foraminal area (FA).

Results

Mean age of the patients was 68.5 ± 10.8. Mean times between postoperative MRI and follow-up MRI were 20.2 ± 11.9 months. Mean disc height increased from 7.6 ± 1.6 to 11.6 ± 1.7 mm at an immediate postoperative period but decreased to 10.1 ± 1.6 mm during follow-up (p < 0.001). SCSA increased from 96.9 ± 54.9 to 136.0 ± 72.7 mm2 and 171.4 ± 76.10 mm2 during follow-up (p < 0.001). LFT decreased from 3.9 ± 1.2 to 3.2 ± 0.8 mm (17.9%) and further decreased to 2.9 ± 0.7 mm during follow-up (9.4%) (p < 0.001). LFA decreased from 97.4 ± 36.9 to 86.1 ± 36.9 mm2 (11.6%) and further decreased to 77.2 ± 32.5 mm2 during follow-up (10.3%) (p = 0.001). FA increased from 69.2 ± 26.6 to 96.1 ± 23.0 mm2 and increased to 112.9 ± 23.0 mm2 during follow-up (p < 0.001).

Conclusion

OLIF could decompress the spinal canal and foraminal canal indirectly. Despite the diminishing disc height during the follow-up period, the spinal canal was further increased in size from the remodeling of the ligamentum flavum.

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Change history

  • 07 July 2020

    In the article "Decreasing Thickness and Remodeling of Ligamentum Flavum After Oblique Lumbar Interbody Fusion���, Figure 2 captions contained mistakes as descriptions for the Figure sections were not assigned correctly.

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Authors and Affiliations

  1. Department of Orthopaedics, Naresuan University Hospital, Phitsanulok, Thailand

    Akaworn Mahatthanatrakul

  2. Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, South Korea

    Hyeun Sung Kim

  3. Department of Orthopedics, The First Affiliated Hospital of Xiamen University, Xiamen, People’s Republic of China

    Guang-Xun Lin

  4. Spine Center, Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Jin-Sung Kim

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  1. Akaworn Mahatthanatrakul
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Correspondence to Jin-Sung Kim.

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 J-SK is a consultant for RIWOspine, GmbH, and Elliquence, LLC.

Other authors declare that they have no potential conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This is a retrospective study. For this type of study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Mahatthanatrakul, A., Kim, H.S., Lin, GX. et al. Decreasing thickness and remodeling of ligamentum flavum after oblique lumbar interbody fusion. Neuroradiology 62, 971–978 (2020). https://doi.org/10.1007/s00234-020-02414-y

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  • DOI: https://doi.org/10.1007/s00234-020-02414-y

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