Clinical outcomes of revision posterior lumbar interbody fusion for late deterioration after laminotomy assessed with the Zurich Claudication Questionnaire

Hironobu Sakaura; Takahito Fujimori; Tsuyoshi Sugiura; Shutaro Yamada; Sadaaki Kanayama; Daisuke Ikegami

doi:10.1055/a-2479-4972

Clinical outcomes of revision posterior lumbar interbody fusion for late deterioration after laminotomy assessed with the Zurich Claudication Questionnaire

J Neurol Surg A Cent Eur Neurosurg. 2024 Nov 20. doi: 10.1055/a-2479-4972. Online ahead of print.

Authors

Hironobu Sakaura¹, Takahito Fujimori², Tsuyoshi Sugiura³, Shutaro Yamada⁴, Sadaaki Kanayama⁴, Daisuke Ikegami⁴

Affiliations

¹ Orthopaedic Surgery, Suita Municipal Hospital, Suita, Japan.
² Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
³ Orthopaedic Surgery, General Incorporated Foundation Sumitomo Hospital, Osaka, Japan.
⁴ Orthopaedic Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Japan.

PMID: 39566537
DOI: 10.1055/a-2479-4972

Abstract

Study design: A retrospective analysis of prospectively collected data.

Background: There have been a few studies comparing surgical outcomes between revision lumbar fusion surgery and the same primary surgery.

Object: Using the Zurich Claudication Questionnaire (ZCQ), we compared clinical outcomes of revision posterior lumbar interbody fusion (PLIF) for late deterioration after laminotomy with those of primary PLIF to examine whether surgical outcomes of revision PLIF for late deterioration after laminotomy are inferior to those of primary PLIF.

Materials and methods: Sixteen consecutive patients undergoing revision single-level PLIF for late deterioration after single-level laminotomy (R group) and 61 consecutive patients undergoing primary single-level PLIF during the same period as the R group (P group) were enrolled. Before PLIF surgery and at 2-year postoperatively, clinical outcomes were assessed using the ZCQ. Achievement rates of the minimum clinically important difference (MCID) of each domain [Symptom severity (SS) and Physical function (PF)] on the ZCQ were calculated in each group.

Results: In the R group, mean SS and PF before revision PLIF and at 2-year after surgery were 3.429 and 2.8, and 1.946 and 1.6, respectively. In the P group, mean SS and PF before primary PLIF and at postoperative 2-year were 3.438 and 2.5, and 2.194 and 1.6, respectively. Both SS and PF significantly improved at postoperative 2-year in the both groups, and SS both before and after PLIF and PF at 2-year postoperatively showed no significant differences between the 2 groups. Achievement rates of the MCID of SS and PF were 81.3% and 68.8% in the R group, and 59.0% and 59.0% in the P group, respectively. None of the MCID achievement rates of SS and PF showed significant differences between the 2 groups.

Conclusion: Clinical outcomes of revision PLIF for late deterioration after laminotomy were equivalent to those of primary PLIF assessed with the ZCQ at 2 years after PLIF surgery.