Louisiana Research Day Program Book 2025

Anatomy and Epidemiology

Anatomy and Epidemiology

Cook L.,BS1*, Gerges M.,BS1*, Moussaed A., BS1*, Nzeadibe C., BS2*; Zakaria J., BS 1 ; Kang D., BS 1 ; Alvarina J, MD 3 ; Newell S., PhD 2 1 VCOM-Louisiana, Monroe, LA; 2 Lincoln Memorial University DeBusk College of Osteopathic Medicine, Harrogate, TN 47 A HISTORICAL ANALYSIS OF LUMBAR INTERBODY FUSION: EVOLUTION AND ADVANCEMENTS OF THE TECHNIQUES.

Kaitlin Phillips, OMS-II; Nick Villar, OMS-II; Nicholas Wong, OMS-II; Jenna Dittmar, PhD VCOM-Louisiana 48 EXAMINING THE RELATIONSHIP BETWEEN THE FIRST METATARSAL LENGTH AND THE PRESENCE OF HALLUX VALGUS

Context: Lumbar interbody fusion (LIF) has evolved since the 19th century into a critical procedure for treating lumbar spine pathologies. Advances in surgical strategies, imaging, and technology have transformed LIF from invasive methods to minimally invasive and robotic assisted procedures, improving outcomes by reducing complications and recovery time. Objective: This review examines the historical development and efficacy of key approaches, including posterior (PLIF), transforaminal (TLIF), anterior (ALIF), lateral (LLIF), oblique (OLIF), and endoscopic (ELIF) techniques. Understanding this evolution highlights the progress and future potential of LIF in spinal surgery. Methods: A comprehensive historical review of published literature was conducted, identifying a total of 275 works. This pool was subsequently refined to 39 key papers, which were analyzed to explore the differences and advancements in surgical approaches. Results: Examining LIF approaches highlights key differences between each surgical technique. PLIF employs a bilateral approach,

while TLIF utilizes a unilateral approach to address neural decompression and spinal stabilization with interbody cage placement. ALIF utilizes a retroperitoneal route to minimize posterior structure disruption, while LLIF and OLIF use lateral and oblique pathways, respectively, to enable minimally invasive access. ELIF, incorporates endoscopic visualization and CT-guided robotic assistance to minimize tissue disruption, facilitating faster recovery. Understanding each approach provides insight into the reasoning behind variations of LIF procedures. The progression of advancements in LIF procedures has had a significant impact on patient outcomes. The shift from open to minimally invasive techniques, including endoscopy and robotic assistance, has led to reduced intraoperative blood loss, shorter recovery times, and a lower risk of neural injuries. However, differences in the duration of surgery, cost, and the surgeon’s skill level and comfort with the procedure remain important factors to consider.

Conclusions: This study traces the evolution of LIF techniques, highlighting advancements from invasive open procedures to minimally invasive approaches with increased utilization of endoscopy and robotic assistance. By analyzing PLIF, TLIF, ALIF, LLIF, OLIF, and ELIF, we demonstrate how innovations in tools, imaging, and biomechanics have improved outcomes and expanded treatment options. While significant progress has been made, further research is needed to assess long-term outcomes and cost effectiveness, ensuring continued refinement of these transformative spinal procedures.

Context: Hallux valgus is a common deformity of the great toe that affects many individuals and can cause problems daily. This research can be used to determine if an individual has an increased risk of developing hallux valgus which would allow for the possibility of early treatment or preventative intervention. Objective: The aim of this project is to examine the relationship between the length of the first metatarsal and the presence of hallux valgus. Materials: The feet of thirty-one formalin emblemed cadavers (M=13, F=17) at VCOM Louisiana –Louisiana were macroscopically and radiographically assessed. Methods: An osteometric board was used to determine the maximum length of the first metatarsal, digital calipers (accuracy 0.01mm) were used to determine the height of the distal articular surface and the functional length of the first metatarsal. The presence and severity of hallux valgus was determined using the Manchester scale (graded on a scale from 1-4). Hallux valgus was considered present if the angle formed between the longitudinal bisection

of the first metatarsal and the proximal phalanx was greater than 15 degrees (grades 2-4 on the Manchester scale). Results: On average, the length of the first metatarsal was longer among the men, and the presence of hallux valgus was more common among women, but this is not statistically significant (Fisher exact test=0.1129, p < .05). Women without hallux valgus (grade 1) had an average first metatarsal length of 67.22mm on the left and 66.44mm on the right. In women with mild hallux valgus (grade 2), the left metatarsal average was 66.33mm and the right was 68mm. Moderate deformity (grade 3) in women was associated with an average length of 66.5mm on the left and 66.5mm on the right. Men without hallux valgus had an average length of 72mm on the left and 72.14mm on the right. Those with mild deformity had an average length of 70.4mm on the left and 70.67mm on the right. Moderate deformity among men was only seen on the left foot of two men with an average length of 75mm. No examples of severe deformity (grade 4) were found. A series of independent T-tests demonstrated that there was no statistically significant difference in the

length of the first metatarsals in women or men that had HV and those who did not (women: right MT1, p=0.57; left MT1, p=0.58, men: right MT1: p=0.54; left MT1: p=0.90). Conclusions: From these results, there does not appear to be a relationship between the length of the first metatarsal and severity of hallux valgus deformity. Additional research should be conducted to further investigate this relationship.

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2025 Research Recognition Day