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Research article
Wei Zhou
Corresponding Author
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Background:
To investigate the early efficacy of the bilateral decompression via unilateral approach versus conventional approach transforaminal lumbar interbody fusion(TLIF)for the treatment of lumbar degenerative disc disease in the patients over 65 years of age, especially in the perioperative factors and the recovery of the soft tissue.
Methods:
The clinical data from 61 aging patients with lumbar degenerative disease who received surgical treatment were retrospectively analyzed. 31 cases who received the lumbar interbody fusion surgery with bilateral decompression via unilateral approach (BDUA) were compared with 30 cases who received conventional approach transforaminal lumbar interbody fusion. The radiographic parameters were measured using X-ray including lumbar lordosis angle and fusion rate. Japanese Orthopedic Association (JOA), Visual Analogue Scale (VAS) and Oswestry Disability Index（ODI）scores were used to evaluate the clinical outcomes at different time points. Fatty degeneration ratio and area of muscle/vertebral body were used to detect recovery of soft tissue.
Results:
All 61 patients received the BDUA approach and conventional approach transforaminal lumbar interbody fusion under general anesthesia. The BDUA approach group was found to have significantly less intraoperative blood loss and postoperative drainage compared to conventional approach transforaminal lumbar interbody fusion group. Symptoms of spinal cord and nerve compression were significantly relieved postoperatively, as compared with the preoperative state. However, the opposite side had a lower rate of fatty degeneration comparing to decompression side (P<0.05) six months after surgery in the BDUA group. While there were no significant differences (P>0.05) in two sides of conventional transforaminal lumbar interbody fusion approach group six months after surgery.
Conclusions:
Bilateral decompression via unilateral approach (BDUA) is able to reduce the intraoperative and postoperative body fluid loss in the elderly. The opposite side of depression in BDUA shows less fatty degeneration, which indicates better recovery of the soft tissue of the aging patients.
Keywords
Bilateral decompression via unilateral approach, lumbar degenerative disease, fatty degeneration
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CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Review #2 received
Received 13 Jan, 2021
Review #1 received
Received 12 Jan, 2021
Reviewer #2 agreed
On 08 Jan, 2021
Reviewers invited
Invitations sent on 05 Jan, 2021
Reviewer #1 agreed
On 05 Jan, 2021
Editor assigned
On 30 Nov, 2020
Submission checks complete
On 30 Nov, 2020
Editor invited
On 30 Nov, 2020
Version 1
Posted 15 Jun, 2020
No comments provided
Editorial decision: Major revision
On 29 Oct, 2020
Review #2 received
Received 28 Oct, 2020
Reviewer #2 agreed
On 26 Oct, 2020
Review #1 received
Received 07 Sep, 2020
Reviewer #1 agreed
On 26 Aug, 2020
Reviewers invited
Invitations sent on 04 Jul, 2020
Editor assigned
On 25 Jun, 2020
Submission checks complete
On 11 Jun, 2020
Editor invited
On 11 Jun, 2020
First submitted
On 05 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Musculoskeletal Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Wei Zhou
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Review #2 received
Received 13 Jan, 2021
Review #1 received
Received 12 Jan, 2021
Reviewer #2 agreed
On 08 Jan, 2021
Reviewers invited
Invitations sent on 05 Jan, 2021
Reviewer #1 agreed
On 05 Jan, 2021
Editor assigned
On 30 Nov, 2020
Submission checks complete
On 30 Nov, 2020
Editor invited
On 30 Nov, 2020
Version 1
Posted 15 Jun, 2020
No comments provided
Editorial decision: Major revision
On 29 Oct, 2020
Review #2 received
Received 28 Oct, 2020
Reviewer #2 agreed
On 26 Oct, 2020
Review #1 received
Received 07 Sep, 2020
Reviewer #1 agreed
On 26 Aug, 2020
Reviewers invited
Invitations sent on 04 Jul, 2020
Editor assigned
On 25 Jun, 2020
Submission checks complete
On 11 Jun, 2020
Editor invited
On 11 Jun, 2020
First submitted
On 05 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
Background:
To investigate the early efficacy of the bilateral decompression via unilateral approach versus conventional approach transforaminal lumbar interbody fusion(TLIF)for the treatment of lumbar degenerative disc disease in the patients over 65 years of age, especially in the perioperative factors and the recovery of the soft tissue.
Methods:
The clinical data from 61 aging patients with lumbar degenerative disease who received surgical treatment were retrospectively analyzed. 31 cases who received the lumbar interbody fusion surgery with bilateral decompression via unilateral approach (BDUA) were compared with 30 cases who received conventional approach transforaminal lumbar interbody fusion. The radiographic parameters were measured using X-ray including lumbar lordosis angle and fusion rate. Japanese Orthopedic Association (JOA), Visual Analogue Scale (VAS) and Oswestry Disability Index（ODI）scores were used to evaluate the clinical outcomes at different time points. Fatty degeneration ratio and area of muscle/vertebral body were used to detect recovery of soft tissue.
Results:
All 61 patients received the BDUA approach and conventional approach transforaminal lumbar interbody fusion under general anesthesia. The BDUA approach group was found to have significantly less intraoperative blood loss and postoperative drainage compared to conventional approach transforaminal lumbar interbody fusion group. Symptoms of spinal cord and nerve compression were significantly relieved postoperatively, as compared with the preoperative state. However, the opposite side had a lower rate of fatty degeneration comparing to decompression side (P<0.05) six months after surgery in the BDUA group. While there were no significant differences (P>0.05) in two sides of conventional transforaminal lumbar interbody fusion approach group six months after surgery.
Conclusions:
Bilateral decompression via unilateral approach (BDUA) is able to reduce the intraoperative and postoperative body fluid loss in the elderly. The opposite side of depression in BDUA shows less fatty degeneration, which indicates better recovery of the soft tissue of the aging patients.
Figure 1
Figure 2
Figure 3
Figure 4
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