• Shuhei Ohyama, Yasuchika Aoki, Masahiro Inoue, Takayuki Nakajima, Yusuke Sato, Masashi Sato, Satoshi Yoh, Hiroshi Takahashi, Arata Nakajima, Toshiaki Kotani, Yawara Eguchi, Sumihisa Orita, Kazuhide Inage, Yasuhiro Shiga, Koichi Nakagawa, and Seiji Ohtori.
• Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane, Chiba, Japan.
• World Neurosurg. 2023 May 1; 173: e727e737e727-e737.

ObjectiveThis 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.MethodsWe included 106 patients (age, 67.4 ± 10.4 years; 51 male/55 female) with lumbar degenerative diseases, who were treated with single-level transforaminal lumbar interbody fusion. Severity of VP (SVP) score was measured preoperatively. SVP score at fused disc was used as SVP (FS) score and at nonfused discs was used as SVP (non-FS) score. Surgical outcomes were assessed using the Oswestry Disability Index (ODI) and visual analog 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 2 groups. Correlations between each SVP score and surgical outcomes were analyzed.ResultsThere were no differences in surgical outcomes between the severe VP (FS) and mild VP (FS) groups. Postoperative ODI, VAS score 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 score for LBP, lower extremity pain, numbness, and LBP in standing; however, SVP (FS) scores did not correlate with any surgical outcomes.ConclusionsPreoperative SVP at fused disc is not associated with surgical outcomes; however, SVP at nonfused discs is correlated with clinical outcomes.Copyright © 2023 Elsevier Inc. All rights reserved.

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