Does transforaminal lumbar interbody fusion produce leg pain? Results from a RCT

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Does transforaminal lumbar interbody fusion produce leg pain? Results from a RCT. / Høy, Kristian; Grycel, Blazej; Andersen, Thomas et al.

I: Journal of Orthopaedic Surgery, Bind 27, Nr. 3, 2019.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Høy K, Grycel B, Andersen T, Bünger C. Does transforaminal lumbar interbody fusion produce leg pain? Results from a RCT. Journal of Orthopaedic Surgery. 2019;27(3). doi: 10.1177/2309499019869469

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Høy, Kristian ; Grycel, Blazej ; Andersen, Thomas et al. / Does transforaminal lumbar interbody fusion produce leg pain? Results from a RCT. I: Journal of Orthopaedic Surgery. 2019 ; Bind 27, Nr. 3.

Bibtex

@article{b13ce5f7e45a4251bffa417a734c44a8,
title = "Does transforaminal lumbar interbody fusion produce leg pain?: Results from a RCT",
abstract = "BACKGROUND: Transforaminal lumbar interbody fusion (TLIF) is presently the most used method to achieve lumbar interbody fusion worldwide. The special preparation and cage insertion imply a risk of an undesirable side effect in the form of residual neurogenic pain. This issue has not been investigated prior in a randomized clinical trial (RCT) set up. AIM: To test whether TLIFs had a higher incidence of leg pain in comparison to a common instrumented posterolateral fusion (PLF) and to test whether a higher occurrence of leg pain on the ipsilateral side in the TLIF group was present. METHODS: One hundred patients included in a RCT comparing TLIF and PLF fulfilled pain drawings and numeric rating scale (NRS) scale from 0 to 10 preoperatively, after 1 year, and after 2 years. Difference in pain appearance, type, localization, and intensity was compared between groups. RESULTS: A slightly higher number of patients in the TLIF group reported leg pain at 2 years follow-up: no leg pain, 47% (PLF) and 37% (TLIF); unilateral leg pain, 31% (PLF) and 25% (TLIF); bilateral leg pain, 22% (PLF) and 37% (TLIF), p = 0.270. Numbness and pins and needles on the anterior aspect of the lower leg were marked by 10% and 12% of TLIF patients compared to 6% and 4% in PLF patients p = 0.498/0.197. The ipsilateral side of cage insertion in the TLIF group was not a place for new leg pain compared to the contralateral side. CONCLUSION: The special surgical preparation used in TLIFs does not result in the development of new ipsilateral leg pain. However, a higher percentage of the patients in the TLIF group had new leg pain in comparison to PLF after 2 years.",
keywords = "pain drawings, randomized clinical trial, residual neurogenic pain, transforaminal interbody lumbar fusion",
author = "Kristian H{\o}y and Blazej Grycel and Thomas Andersen and Cody B{\"u}nger",
year = "2019",
doi = "10.1177/2309499019869469",
language = "English",
volume = "27",
journal = "Journal of Orthopaedic Surgery",
issn = "1022-5536",
publisher = "Hong Kong Academy of Medicine Press",
number = "3",

}

RIS

TY - JOUR

T1 - Does transforaminal lumbar interbody fusion produce leg pain?

T2 - Results from a RCT

AU - Høy, Kristian

AU - Grycel, Blazej

AU - Andersen, Thomas

AU - Bünger, Cody

PY - 2019

Y1 - 2019

N2 - BACKGROUND: Transforaminal lumbar interbody fusion (TLIF) is presently the most used method to achieve lumbar interbody fusion worldwide. The special preparation and cage insertion imply a risk of an undesirable side effect in the form of residual neurogenic pain. This issue has not been investigated prior in a randomized clinical trial (RCT) set up. AIM: To test whether TLIFs had a higher incidence of leg pain in comparison to a common instrumented posterolateral fusion (PLF) and to test whether a higher occurrence of leg pain on the ipsilateral side in the TLIF group was present. METHODS: One hundred patients included in a RCT comparing TLIF and PLF fulfilled pain drawings and numeric rating scale (NRS) scale from 0 to 10 preoperatively, after 1 year, and after 2 years. Difference in pain appearance, type, localization, and intensity was compared between groups. RESULTS: A slightly higher number of patients in the TLIF group reported leg pain at 2 years follow-up: no leg pain, 47% (PLF) and 37% (TLIF); unilateral leg pain, 31% (PLF) and 25% (TLIF); bilateral leg pain, 22% (PLF) and 37% (TLIF), p = 0.270. Numbness and pins and needles on the anterior aspect of the lower leg were marked by 10% and 12% of TLIF patients compared to 6% and 4% in PLF patients p = 0.498/0.197. The ipsilateral side of cage insertion in the TLIF group was not a place for new leg pain compared to the contralateral side. CONCLUSION: The special surgical preparation used in TLIFs does not result in the development of new ipsilateral leg pain. However, a higher percentage of the patients in the TLIF group had new leg pain in comparison to PLF after 2 years.

AB - BACKGROUND: Transforaminal lumbar interbody fusion (TLIF) is presently the most used method to achieve lumbar interbody fusion worldwide. The special preparation and cage insertion imply a risk of an undesirable side effect in the form of residual neurogenic pain. This issue has not been investigated prior in a randomized clinical trial (RCT) set up. AIM: To test whether TLIFs had a higher incidence of leg pain in comparison to a common instrumented posterolateral fusion (PLF) and to test whether a higher occurrence of leg pain on the ipsilateral side in the TLIF group was present. METHODS: One hundred patients included in a RCT comparing TLIF and PLF fulfilled pain drawings and numeric rating scale (NRS) scale from 0 to 10 preoperatively, after 1 year, and after 2 years. Difference in pain appearance, type, localization, and intensity was compared between groups. RESULTS: A slightly higher number of patients in the TLIF group reported leg pain at 2 years follow-up: no leg pain, 47% (PLF) and 37% (TLIF); unilateral leg pain, 31% (PLF) and 25% (TLIF); bilateral leg pain, 22% (PLF) and 37% (TLIF), p = 0.270. Numbness and pins and needles on the anterior aspect of the lower leg were marked by 10% and 12% of TLIF patients compared to 6% and 4% in PLF patients p = 0.498/0.197. The ipsilateral side of cage insertion in the TLIF group was not a place for new leg pain compared to the contralateral side. CONCLUSION: The special surgical preparation used in TLIFs does not result in the development of new ipsilateral leg pain. However, a higher percentage of the patients in the TLIF group had new leg pain in comparison to PLF after 2 years.

KW - pain drawings

KW - randomized clinical trial

KW - residual neurogenic pain

KW - transforaminal interbody lumbar fusion

UR - http://www.scopus.com/inward/record.url?scp=85072303467&partnerID=8YFLogxK

U2 - 10.1177/2309499019869469

DO - 10.1177/2309499019869469

M3 - Journal article

C2 - 31530081

AN - SCOPUS:85072303467

VL - 27

JO - Journal of Orthopaedic Surgery

JF - Journal of Orthopaedic Surgery

SN - 1022-5536

IS - 3

ER -