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

Abstract

This study aimed to examine whether preoperative severity and location of lumbar intervertebral disc vacuum phenomenon (VP) influence surgical outcomes after single-level transforaminal lumbar interbody fusion (TLIF). We included 106 patients (age: 67.4 ± 10.4 years; 51 male/55 female) with lumbar degenerative diseases, who were treated with single-level TLIF. Severity of VP (SVP) score was measured preoperatively. SVP score at fused disc was used as SVP (FS) score, and at non-fused discs was used as SVP (non-FS) score. Surgical outcomes were assessed using Oswestry disability index (ODI) and visual analogue scale (VAS; low back pain (LBP), lower-extremity pain, numbness, 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 two groups. Correlations between each SVP score and surgical outcomes were analyzed. There were no differences in surgical outcomes between the Severe VP (FS) and Mild VP (FS) groups. Postoperative ODI, VAS for LBP, lower-extremity pain, numbness, 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 for LBP, lower extremity pain, numbness, and LBP in standing; however, SVP (FS) scores did not correlate with any surgical outcomes. Preoperative severity of VP at fused disc is not associated with surgical outcomes, however, severity of VP at non-fused discs is correlated with clinical outcomes.