PMID- 38193931 OWN - NLM STAT- MEDLINE DCOM- 20240411 LR - 20240411 IS - 1528-1159 (Electronic) IS - 0362-2436 (Linking) VI - 49 IP - 9 DP - 2024 May 1 TI - The Impact of Posterior Intervertebral Osteophytes on Patient-Reported Outcome Measures After L5-S1 Anterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion. PG - 652-660 LID - 10.1097/BRS.0000000000004904 [doi] AB - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: (1) To develop a reliable grading system to assess the severity of posterior intervertebral osteophytes and (2) to investigate the impact of posterior intervertebral osteophytes on clinical outcomes after L5-S1 decompression and fusion through anterior lumbar interbody fusion (ALIF) and minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF). BACKGROUND: There is limited evidence regarding the clinical implications of posterior lumbar vertebral body osteophytes for ALIF and MIS-TLIF surgeries and there are no established grading systems that define the severity of these posterior lumbar intervertebral osteophytes. PATIENTS AND METHODS: A retrospective analysis of patients undergoing L5-S1 ALIF or MIS-TLIF was performed. Preoperative and postoperative patient-reported outcome measures of the Oswestry Disability Index (ODI) and leg Visual Analog Scale (VAS) at 2-week, 6-week, 12-week, and 6-month follow-up time points were assessed. Minimal clinically important difference (MCID) for ODI of 14.9 and VAS leg of 2.8 were utilized. Osteophyte grade was based on the ratio of osteophyte length to foraminal width. "High-grade" osteophytes were defined as a maximal osteophyte length >50% of the total foraminal width. RESULTS: A total of 70 consecutive patients (32 ALIF and 38 MIS-TLIF) were included in the study. There were no significant differences between the two cohorts in patient-reported outcome measures or achievement of MCID for Leg VAS or ODI preoperatively or at any follow-ups. On multivariate analysis, neither the surgical approach nor the presence of high-grade foraminal osteophytes was associated with leg VAS or ODI scores at any follow-up time point. In addition, neither the surgical approach nor the presence of high-grade foraminal osteophytes was associated with the achievement of MCID for leg VAS or ODI at 6 months. CONCLUSION: ALIF and MIS-TLIF are both valid options for treating degenerative spine conditions and lumbar radiculopathy, even in the presence of high-grade osteophytes that significantly occupy the intervertebral foramen. LEVEL OF EVIDENCE: 3. CI - Copyright (c) 2024 Wolters Kluwer Health, Inc. All rights reserved. FAU - Zhao, Eric AU - Zhao E AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. AD - Department of Spine Surgery, Weill Cornell Medicine, New York, NY. FAU - Hirase, Takashi AU - Hirase T AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Kim, Andrew G AU - Kim AG AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Du, Jerry Y AU - Du JY AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Amen, Troy B AU - Amen TB AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Araghi, Kasra AU - Araghi K AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Subramanian, Tejas AU - Subramanian T AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. AD - Department of Spine Surgery, Weill Cornell Medicine, New York, NY. FAU - Kamil, Robert AU - Kamil R AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Shahi, Pratyush AU - Shahi P AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Fourman, Mitchell S AU - Fourman MS AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Asada, Tomoyuki AU - Asada T AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Simon, Chad Z AU - Simon CZ AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Singh, Nishtha AU - Singh N AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Korsun, Maximilian AU - Korsun M AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Tuma, Olivia C AU - Tuma OC AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Zhang, Joshua AU - Zhang J AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Lu, Amy Z AU - Lu AZ AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. AD - Department of Spine Surgery, Weill Cornell Medicine, New York, NY. FAU - Mai, Eric AU - Mai E AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. AD - Department of Spine Surgery, Weill Cornell Medicine, New York, NY. FAU - Kim, Ashley Yeo Eun AU - Kim AYE AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. AD - Department of Spine Surgery, Weill Cornell Medicine, New York, NY. FAU - Allen, Myles R J AU - Allen MRJ AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Kwas, Cole AU - Kwas C AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Dowdell, James E AU - Dowdell JE AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Sheha, Evan D AU - Sheha ED AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Qureshi, Sheeraz A AU - Qureshi SA AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. FAU - Iyer, Sravisht AU - Iyer S AD - Department of Spine Surgery, Hospital for Special Surgery, New York, NY. LA - eng PT - Journal Article DEP - 20240108 PL - United States TA - Spine (Phila Pa 1976) JT - Spine JID - 7610646 SB - IM MH - Humans MH - Retrospective Studies MH - Treatment Outcome MH - Lumbar Vertebrae/diagnostic imaging/surgery MH - *Osteophyte/diagnostic imaging/surgery MH - Minimally Invasive Surgical Procedures MH - *Spinal Fusion MH - *Intervertebral Disc Degeneration/surgery MH - Patient Reported Outcome Measures COIS- M.S.F has the following disclosures: Johnson & Johnson: Paid consultant. S.Q. has the following disclosures: AMOpportunities: Other financial or material support; Annals of Translational Medicine: Editorial or governing board; Association of Bone and Joint Surgeons: Board or committee member; Cervical Spine Research Society: Board or committee member; Contemporary Spine Surgery: Editorial or governing board; Globus Medical: IP royalties; Paid consultant; Paid presenter or speaker; Hospital Special Surgery Journal: Editorial or governing board; HS2, LLC: Stock or stock Options; International Society for the Advancement of Spine Surgery (ISASS) - Program Committee member: Board or committee member; Lifelink.com: Other financial or material support; Lumbar Spine Research Society: Board or committee member; Minimally Invasive Spine Study Group: Board or committee member; North American Spine Society: Board or committee member; Simplify Medical, Inc.: Other financial or material support; Society of Minimally Invasive Spine Surgery (SMISS) - Program Committee member: Board or committee member; Spinal Simplicity: Other financial or material support; SpineGuard, Inc.: Paid consultant; Stryker: IP royalties; Paid consultant; Surgalign: Paid consultant; Tissue Differentiation Intelligence: Stock or stock Options; Viseon, Inc.: Paid consultant; Research support. S.I. has the following disclosures: Globus Medical: Paid presenter or speaker; Stryker: Paid presenter or speaker; Vertebral Columns/International Society for the Advancement of Spine Surgery (ISASS): Editorial or governing board. The remaining authors report no conflicts of interest. EDAT- 2024/01/09 13:46 MHDA- 2024/04/11 06:42 CRDT- 2024/01/09 11:04 PHST- 2023/09/08 00:00 [received] PHST- 2023/12/11 00:00 [accepted] PHST- 2024/04/11 06:42 [medline] PHST- 2024/01/09 13:46 [pubmed] PHST- 2024/01/09 11:04 [entrez] AID - 00007632-990000000-00549 [pii] AID - 10.1097/BRS.0000000000004904 [doi] PST - ppublish SO - Spine (Phila Pa 1976). 2024 May 1;49(9):652-660. doi: 10.1097/BRS.0000000000004904. Epub 2024 Jan 8.