Can Fan-Beam Interactive Computed Tomography Accurately Predict Indirect Decompression in Minimally Invasive Spine Surgery Fusion Procedures?

Lateral Lumbar Interbody Fusion: What is the Evidence of Indirect Neural Decompression? A Systematic Review of the Literature

“…In seven case series, a distinction between the two foraminal sides could be performed: 37.7 ± 31.6 mm 2 left FA versus 37.2 ± 36.3 mm 2 right FA [9,20,23,27,30,37,55]. Nine papers reported variations in both DH (X) and FA (Y) [9,20,23,27,37,40,43,55,59]. The outcome of the corresponding regression The canal area (CA) was evaluated by ten authors [9,14,19,20,37,40,43,55,59,60].…”

“…Nine papers reported variations in both DH (X) and FA (Y) [9,20,23,27,37,40,43,55,59]. The outcome of the corresponding regression The canal area (CA) was evaluated by ten authors [9,14,19,20,37,40,43,55,59,60]. The mean CA increase was estimated at 36.4 ± 26.3 mm 2 (95% CI, 18.1-54.7; mean increase, 29.3%).…”

“…The height of the implanted cages was available for 705 levels: 64 were 8 mm (9.1%), 229 were 10 mm (32.4%), 277 were 12 mm (39.2%), 121 were 14 mm (17.1%), and only 14 were 16 mm (2.0%) [6, 9, 12, 18–20, 31, 40]. For 1030 levels, the type of cage was described: 861 were lordotic (6 to 10°) and 169 were parallel cages [6, 9, 12, 13, 17–20, 22–24, 40].…”

“…The height of the implanted cages was available for 705 levels: 64 were 8 mm (9.1%), 229 were 10 mm (32.4%), 277 were 12 mm (39.2%), 121 were 14 mm (17.1%), and only 14 were 16 mm (2.0%) [6, 9, 12, 18–20, 31, 40]. For 1030 levels, the type of cage was described: 861 were lordotic (6 to 10°) and 169 were parallel cages [6, 9, 12, 13, 17–20, 22–24, 40]. Five authors reported the sagittal cage position in disc space, dividing the vertebral plate into anterior, middle, and posterior thirds; data were available for 379 cages: 134 were included in the anterior third (35.4%), 207 in the middle third (54.6%), and only 38 in the posterior third (10.0%) [24, 25, 27, 37, 43].…”

“…The authors reported clinical status with different outcome scales, the most common being the ODI score and the VAS score for back and leg pain. The level of disability was evaluated with ODI in 26 studies, with a mean improvement of 21.86 ± 7.22 points (95% CI, 18.8–24.9) [4–8, 10–14, 18, 20–24, 29–32, 34, 36, 37, 39, 41, 43]. The mean ODI variation extrapolated from the included studies was 47.6 ± 10.3% (range, 33–72), which was superior to the reported minimum clinically important difference of ODI (11%) after adult spinal deformity surgery [61].…”