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Original Article
Journal of Korean Neurosurgical Society 2007;41(6): 377-381.
A Morphometric Analysis of Neuroforamen in Grade I Isthmic Spondylolisthesis by Anterior Lumbar Interbody Fusion with Pedicle Screw Fixation.
Dong Yeob Lee, Sang Ho Lee, Seok Kang Kim, Dae Hyeon Maeng, Jee Soo Jang
1Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea. nsspine@paran.com
2Department of Neurosurgery, Gimpo Airport Wooridul Spine Hospital, Seoul, Korea.
3Department of Thoracic and Cardiovascular Surgery, Gimpo Airport Wooridul Spine Hospital, Seoul, Korea.
ABSTRACT
OBJECTIVE
S: The aim of this study was to evaluate the morphometric changes in neuroforamen in grade I isthmic spondylolisthesis by anterior lumbar interbody fusion (ALIF).
METHODS
Fourteen patients with grade I isthmic spondylolisthesis who underwent single level ALIF with percutaneous pedicle screw fixation were enrolled. All patients underwent standing lateral radiography and magnetic resonance imaging (MRI) before surgery and at 1 week after surgery. For quantitative analysis, the foraminal height, foraminal width, epidural foraminal height, epidural foraminal width, and epidural foraminal area were evaluated at the mid-portion of 28 foramens using T2-weighted sagittal MRI. For qualitative analysis, degree of neural compression in mid-portion of 28 foramens was classified into 4 grades using T2-weighted sagittal MRI. Clinical outcomes were assessed using Visual Analogue Sale (VAS) scores for leg pain and Oswestry disability index before surgery and at 1 year after surgery.
RESULTS
The affected levels were L4-5 in 10 cases and L5-S1 in 4. The mean foraminal height was increased (p<0.001), and the mean foraminal width was decreased (p=0.014) significantly after surgery. The mean epidural foraminal height (p<0.001), epidural foraminal width (p<0.001), and epidural foraminal area (p<0.001) showed a significant increase after surgery. The mean grade for neural compression was decreased significantly after surgery (p<0.001). VAS scores for leg pain (p=0.001) and Oswestry disability index (p=0.001) was decreased significantly at one year after surgery.
CONCLUSION
Foraminal stenosis in grade I isthmic spondylolisthesis may effectively decompressed by ALIF with percutaneous pedicle screw fixation.
Key Words: Anterior lumbar interbody fusion (ALIF); Isthmic spondylolisthesis; Neuroforamen
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