Silviu Sabou1, Tzu-Heng Jason Tseng2, John Stephenson3, Irfan Siddique2, Rajat Verma2, Saeed Mohammad2. 1. Department of Spinal Surgery, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK. silviusabou@yahoo.com. 2. Department of Spinal Surgery, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK. 3. School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
Abstract
PURPOSE: Limited data is available in the literature on the radiographic results of multilevel posterior lumbar interbody fusion (MPLIF) in the treatment of degenerative scoliosis. The objective of our study was to evaluate the segmental and global correction achieved with MPLIF in the treatment of degenerative scoliosis. METHODS: Between 2009 and 2014, 42 patients underwent correction of degenerative scoliosis with MPLIF. Several radiological parameters were measured pre- and post-operatively by two independent observers. A statistical analysis was performed to assess the inter-observer reliability of the measurements and to determine the degree of segmental correction achieved at each intervertebral disc. Using sagittal vertical axis (SVA) less than 47 mm; lumbar lordosis (LL) within 11° of pelvic incidence (PI); and pelvic tilt (PT) no more than 22° as radiological criteria for procedural acceptability, we determined predictive factors for a favourable radiological outcome. RESULTS: Forty-two patients (34 female) were included in our study. The average amount of correction per segment was 6.2°. The overall correction achieved with MPLIF was 16.6°. Twenty-six of the 42 patients (61.9 %) had post-operative SVA values less than 47 mm. Nineteen of the 42 patients (45.2 %) had average post-operative LL within 11° of the PI. Sixteen of the 42 patients (38.1 %) had PT less than 22°. Younger age, female gender and a low pre-operative PT were significantly associated with the attainment of a satisfactory sagittal alignment. CONCLUSION: Our results demonstrate that a satisfactory correction can be achieved in degenerative scoliosis with MPLIF. In addition, our results show that it is significantly more likely to achieve a satisfactory radiological outcome in younger, female patients with low pre-operative PT.
PURPOSE: Limited data is available in the literature on the radiographic results of multilevel posterior lumbar interbody fusion (MPLIF) in the treatment of degenerative scoliosis. The objective of our study was to evaluate the segmental and global correction achieved with MPLIF in the treatment of degenerative scoliosis. METHODS: Between 2009 and 2014, 42 patients underwent correction of degenerative scoliosis with MPLIF. Several radiological parameters were measured pre- and post-operatively by two independent observers. A statistical analysis was performed to assess the inter-observer reliability of the measurements and to determine the degree of segmental correction achieved at each intervertebral disc. Using sagittal vertical axis (SVA) less than 47 mm; lumbar lordosis (LL) within 11° of pelvic incidence (PI); and pelvic tilt (PT) no more than 22° as radiological criteria for procedural acceptability, we determined predictive factors for a favourable radiological outcome. RESULTS: Forty-two patients (34 female) were included in our study. The average amount of correction per segment was 6.2°. The overall correction achieved with MPLIF was 16.6°. Twenty-six of the 42 patients (61.9 %) had post-operative SVA values less than 47 mm. Nineteen of the 42 patients (45.2 %) had average post-operative LL within 11° of the PI. Sixteen of the 42 patients (38.1 %) had PT less than 22°. Younger age, female gender and a low pre-operative PT were significantly associated with the attainment of a satisfactory sagittal alignment. CONCLUSION: Our results demonstrate that a satisfactory correction can be achieved in degenerative scoliosis with MPLIF. In addition, our results show that it is significantly more likely to achieve a satisfactory radiological outcome in younger, female patients with low pre-operative PT.
Authors: Yaser M K Baghdadi; A Noelle Larson; Mark B Dekutoski; Quanqi Cui; Arjun S Sebastian; Bryan M Armitage; Ahmad Nassr Journal: Spine (Phila Pa 1976) Date: 2014-02-01 Impact factor: 3.468
Authors: Frank J Schwab; Benjamin Blondel; Shay Bess; Richard Hostin; Christopher I Shaffrey; Justin S Smith; Oheneba Boachie-Adjei; Douglas C Burton; Behrooz A Akbarnia; Gregory M Mundis; Christopher P Ames; Khaled Kebaish; Robert A Hart; Jean-Pierre Farcy; Virginie Lafage Journal: Spine (Phila Pa 1976) Date: 2013-06-01 Impact factor: 3.468