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Abstract
Objectives
To analyze the height changes of the intervertebral disc and neural foramen and width changes of the neural foramen after anterior lumbar interbody fusion and posterior fixation in the lumbar spine.
Summary of Literature Review
A nterior lumbar interbody fusion distracts the height of the intervertebral disc and neural foramen and the width of the neural foramen.
Materials and Methods
Minimal anterior lumbar interbody fusion and posterior fixation were performed in 20 cases from January 1999 to January 2001. The measuring factors were the height of the anterior and posterior discs, and the height and width of the neural foramen, measured with a caliper in 1mm reconstructive, computed tomography, sagittal images before and 6 months after anterior lumbar interbody fusion. The factors were independently measured by three different persons.
Results
The height of the anterior and posterior discs was increased by mean 32.2% and 40.5%, respectively. The height of the right and left neural foramen was increased by mean 15.7% and 18.3%, respectively. The width of the superior, middle and inferior neural foramen was increased by mean 20.6%, 30.3% and 38.6%, respectively. There were significant increases in all measuring factors after minimal anterior lumbar interbody fusion.
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REFERENCES
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 | Fig. 1.Schematic picture for CT measurement were done via sagittal reconstruction at the level of the mid pedicle on axial CT cut |
 | Fig. 2.Diagram showing the measurements made on the discs and neuroforamina. a: anterior disc height, b: posterior disc height, c: foraminal height |
 | Fig. 3.Diagram showing the mesurements made on the neuro-foramina for the width of neuroforamen. d: superior foraminal width, e: middle foraminal width, f: inferior foraminal width. |
 | Fig. 4.A 34-year-old woman with spinal stenosis on L4-5 Fig. 4. (A) Left side sagittal reconstruction image of preoperative CT scan Fig. 4. (B) Left side sagittal reconstruction image of seven-month postoperative CT scan shows marked increase of the anterior disc height, the posterior disc height and the height of neural foramen. |
 | Fig. 5.A 55-year-old woman with spinal stenosis on L4-5 and instability Fig. 4. (A) Left side sagittal reconstruction image of preoperative CT scan Fig. 4. (B) Left side sagittal reconstruction image of six-month postoperative CT scan shows slight increase of the superior, middle and inferior foraminal width. |
Table 1.
The changes of value in CT mesurement
Table 2.
The changes of the height of intervertebral disc in CT mesurement.
| Pre-op (mm) | Post-op (mm) | % increase (%) | |
|---|---|---|---|
| Anterior disc | 7.6 | 9.5 | 32.3 |
| Posterior disc | 5.6 | 7.1 | 40.5 |
Table 3.
The changes of the height of neural foramen in CT mesurement.
| Pre-op (mm) | Post-op (mm) | % increase (%) | |
|---|---|---|---|
| Right | 18.1 | 21.0 | 15.7 |
| Left | 17.7 | 20.9 | 18.3 |
Table 4.
The changes of the width of neural foramen in CT mesurement.
| Pre-op (mm) | Post-op (mm) | % increase (%) | |
|---|---|---|---|
| Sperior | 5.7 | 6.8 | 20.6 |
| Middle | 4.0 | 5.0 | 40.5 |
| Inferior | 3.5 | 4.6 | 38.6 |
Table 5.
The result of paired t-test in postoperative changes of measuring factors.
| Average | S.D.∗ | S.E.∗∗ | t-score | Degree of freedom | p-value | |
|---|---|---|---|---|---|---|
| Height of anterior disc | 2.010 | 1.261 | 0.282 | 7.130 | 19 | < 0.001 |
| Height of posterior disc | 1.495 | 0.841 | 0.188 | 7.952 | 19 | < 0.001 |
| Height of neural foramen | 3.160 | 3.826 | 0.855 | 3.694 | 19 | = 0.002 |
| Width of superior foramen | 1.090 | 0.912 | 0.612 | 1.780 | 19 | < 0.001 |
| Width of middle foramen | 0.950 | 0.919 | 0.482 | 1.971 | 19 | < 0.001 |
| Width of inferior foramen | 1.080 | 1.267 | 0.559 | 1.931 | 19 | = 0.001 |
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