{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T18:50:40Z","timestamp":1791139840065,"version":"4.1.0"},"reference-count":37,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: This study investigated the influence of the vacuum phenomenon (VP) on surgical outcomes in patients with lumbar spinal stenosis, comparing minimally invasive oblique lateral interbody fusion (MIS OLIF) and endoscopic decompression. Methods: A cohort of 110 patients diagnosed with lumbar spinal stenosis underwent either endoscopic decompression or MIS OLIF. Patients were classified into two groups based on the presence or absence of the VP on preoperative CT scans, non-VP (n = 42) and VP (n = 68). Radiologic and clinical outcomes, including back and leg pain assessed using the visual analogue scale (VAS), the Oswestry Disability Index (ODI), and the EuroQol-5 Dimension (Eq5D), were compared pre- and postoperatively over a 2-year follow-up period. Results: Preoperatively, the VP group exhibited significantly greater leg pain (p = 0.010), while no significant differences were observed in back pain or the ODI between the groups. In the non-VP group, decompression and fusion yielded similar outcomes, with decompression showing a better ODI score at 1 month (p = 0.018). In contrast, in the VP group, patients who underwent fusion showed significantly improved long-term leg pain outcomes compared to those who underwent decompression at both 1-year (p = 0.042) and 2-year (p = 0.017) follow-ups. Conclusions: The VP may indicate segmental instability and may play a role in the persistence of radiculopathy. Fusion surgery appears to offer better long-term relief in patients with the VP, whereas decompression alone is a viable option in non-VP cases. These findings suggest that the VP may be a useful factor in guiding surgical decision-making.<\/jats:p>","DOI":"10.3390\/jcm13195827","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T07:19:37Z","timestamp":1727680777000},"page":"5827","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of the Disc Vacuum Phenomenon on Surgical Outcomes in Lumbar Spinal Stenosis: A Comparative Study between Endoscopic Decompression and Minimally Invasive Oblique Lateral Interbody Fusion"],"prefix":"10.3390","volume":"13","author":[{"given":"Hyung Rae","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul 02855, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0877-2742","authenticated-orcid":false,"given":"Kun Joon","family":"Lee","sequence":"additional","affiliation":[{"name":"College of Medicine, Korea University, Seoul 02855, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Yup","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul 02855, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hyuk","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul 02855, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1001\/jama.2022.5921","article-title":"Diagnosis and management of lumbar spinal stenosis: A review","volume":"327","author":"Katz","year":"2022","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.31616\/asj.2023.0409","article-title":"Treatment concept and technical considerations of biportal endoscopic spine surgery for lumbar spinal stenosis","volume":"18","author":"Park","year":"2024","journal-title":"Asian Spine J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"240","DOI":"10.31616\/asj.2022.0015","article-title":"Incidence and skeletal features of developmental cervical and lumbar spinal stenosis","volume":"17","author":"Kasai","year":"2023","journal-title":"Asian Spine J."},{"key":"ref_4","first-page":"261","article-title":"Decision-making algorithm for the surgical treatment of degenerative lumbar spondylolisthesis of L4\/L5","volume":"49","author":"Caffard","year":"2024","journal-title":"Spine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.spinee.2023.12.009","article-title":"Full-endoscopic versus microscopic spinal decompression for lumbar spinal stenosis: A systematic review & meta-analysis","volume":"24","author":"Chin","year":"2024","journal-title":"Spine J."},{"key":"ref_6","first-page":"E1","article-title":"Severe intervertebral vacuum phenomenon is associated with higher preoperative low back pain, ODI, and indication for fusion in patients with degenerative lumbar spondylolisthesis","volume":"37","author":"Caffard","year":"2024","journal-title":"Clin. 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