Our Summary

This study looked at patients who had a specific type of back surgery (Oblique Lumbar Interbody Fusion, or OLIF) and noticed that some of them had different skin temperatures in their lower limbs afterwards. This was due to an injury to a part of the nervous system in the lower back (Lumbar Sympathetic Trunk, or LST) that happened during the surgery. Out of 54 patients, 16 had this temperature difference, which lasted between 1.5 and 12 months. Some of them felt this difference themselves, while others had other symptoms like muscle pain, numbness, and weakness. The study also found that this injury was more common in patients who had surgery on more than one segment of the spine. Most of these patients reported moderate discomfort due to the injury. This study highlights the need to pay attention to this potential complication after back surgery.

FAQs

  1. What is the Oblique Lumbar Interbody Fusion (OLIF) surgery?
  2. What are the complications of the Oblique Lumbar Interbody Fusion (OLIF) surgery as observed in the study?
  3. What is the Lumbar Sympathetic Trunk (LST) and how is it related to changes in skin temperature in the lower limbs?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumbar fusion is to be aware of potential nerve injuries that can occur during the surgery, such as damage to the Lumbar Sympathetic Trunk. It is important to monitor for any changes in skin temperature or other symptoms in the lower limbs following surgery and to report them to your healthcare provider. Additionally, following post-operative instructions and attending follow-up appointments are crucial for monitoring and managing any potential complications.

Suitable For

Patients who are typically recommended lumbar fusion surgery are those who have:

  1. Degenerative disc disease: This is when the discs between the vertebrae in the spine break down, causing pain and instability.

  2. Spondylolisthesis: This is when one vertebra slips forward over the one below it, causing pain and nerve compression.

  3. Spinal stenosis: This is a narrowing of the spinal canal that puts pressure on the spinal cord and nerves, causing pain and other symptoms.

  4. Herniated disc: This is when the gel-like center of a disc in the spine bulges out and puts pressure on nearby nerves, causing pain and other symptoms.

  5. Traumatic injury: Patients who have suffered a traumatic injury to the spine may also be recommended for lumbar fusion surgery to stabilize the spine and relieve pain.

Overall, patients who have not responded to conservative treatments such as medication, physical therapy, and injections may be candidates for lumbar fusion surgery. It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if lumbar fusion surgery is the right choice for them.

Timeline

  1. Pre-surgery: The patient experiences chronic back pain and undergoes various non-surgical treatments such as physical therapy, medications, and injections.
  2. Surgery: The patient undergoes a lumbar fusion procedure to stabilize the spine and alleviate pain. During the surgery, there is a risk of injury to the Lumbar Sympathetic Trunk (LST).
  3. Post-surgery: Some patients may experience temperature differences in their lower limbs due to LST injury, along with symptoms such as muscle pain, numbness, and weakness. This can last between 1.5 and 12 months.
  4. Recovery: Patients may experience moderate discomfort due to the injury and may require additional treatments or therapies to manage their symptoms. It is important for healthcare providers to monitor and address any potential complications following lumbar fusion surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with lumbar fusion surgery?
  2. How common is nerve injury, specifically to the Lumbar Sympathetic Trunk, during lumbar fusion surgery?
  3. What symptoms should I look out for that may indicate nerve injury after surgery?
  4. How long does it typically take for nerve injuries to heal after lumbar fusion surgery?
  5. Are there any specific factors that may increase my risk of nerve injury during surgery?
  6. What can be done to prevent nerve injury during lumbar fusion surgery?
  7. How will nerve injury affect my recovery and long-term outcome after surgery?
  8. Are there any specific tests that can be done to detect nerve injury following lumbar fusion surgery?
  9. What treatment options are available if nerve injury occurs after lumbar fusion surgery?
  10. What follow-up care or monitoring will be necessary to check for nerve injury after surgery?

Reference

Authors: Pan Q, Yu H, He X, Weng Y, Zhang R, Wang H, Li Y. Journal: Orthop Surg. 2023 Apr;15(4):1053-1059. doi: 10.1111/os.13692. Epub 2023 Feb 28. PMID: 36855251