Effect of Preoperative Severity and Location of Lumbar Intervertebral Disc Vacuum Phenomenon on Surgical Outcomes After Single-Level Transforaminal Lumbar Interbody Fusion

-OBJECTIVE: This study aimed to examine whether pre-operative severity and location of lumbar intervertebral disc vacuum phenomenon (VP) influence surgical out-comes after single-level transforaminal lumbar interbody fusion. -METHODS: We included 106 patients (age, 67.4 + 10.4 years; 51 male/55 female) with lumbar degenerative dis-eases, who were treated with single-level transforaminal lumbar interbody fusion. Severity of VP (SVP) score was measured preoperatively. SVP score at fused disc was used as SVP (FS) score and at nonfused discs was used as SVP (non-FS) score. Surgical outcomes were assessed using the Oswestry Disability Index (ODI) and visual analog scale (VAS; low back pain (LBP), lower extremity pain, -umbness, LBP in motion, in standing, and in sitting). The patients were divided into severe VP (FS or non-FS) and mild VP (FS or non-FS) groups, and surgical outcomes were compared between the 2 groups. Correlations between each SVP score and surgical outcomes were analyzed. -RESULTS: There were no differences in surgical out-comes between the severe VP (FS) and mild VP (FS) groups. Postoperative ODI, VAS score for LBP, lower extremity pain, n umbness, and LBP in standing were significantly worse in the severe VP (non-FS) group than in the mild VP (non-FS) group. SVP (non-FS) scores significantly correlated with postoperative ODI, VAS score for LBP, lower extremity pain, n umbness, and LBP in standing; however, SVP (FS) scores did not correlate with any surgical outcomes. -CONCLUSIONS: Preoperative SVP at fused disc is not associated with surgical outcomes; however, SVP at non-fused discs is correlated with clinical outcomes.

Automated summary

This study aimed to investigate whether pre-operative severity and location of lumbar intervertebral disc vacuum phenomenon (VP) influence surgical outcomes after single-level transforaminal lumbar interbody fusion. The study found that surgical outcomes were better in the mild VP (fused/non-fused) group compared to the severe VP (fused/non-fused) group. The severity of non-fused VP was significantly correlated with postoperative clinical outcomes, whereas fused VP showed no correlation with any surgical outcomes.