Matevž Kuhta1, Klemen Bošnjak2, Rok Vengust3. 1. Department of Orthopedic Surgery, University Clinical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia. 2. Department of Orthopedic Surgery, Ljubljana University Medical Centre, Zaloška cesta 9, 1000, Ljubljana, Slovenia. 3. Department of Orthopedic Surgery, Ljubljana University Medical Centre, Zaloška cesta 9, 1000, Ljubljana, Slovenia. rvengust@gmail.com.
Abstract
PURPOSE: The present study aimed to determine whether obtaining adequate lumbar (LL) or segmental (SL) lordosis during instrumented TLIF for one-level degenerative spondylolisthesis affects midterm clinical outcome. METHODS: The study was designed as a prospective one, including 57 patients who underwent single-level TLIF surgery for degenerative spondylolisthesis. Patients were analyzed globally with additional subgroup analysis according to pelvic incidence (PI). Radiographic analysis of spinopelvic sagittal parameters was conducted pre- and postoperatively. Clinical examination including ODI score was performed preoperatively, 1 and 5 years postoperatively. RESULTS: Significant improvement in ODI scores at 1 and 5 years postoperatively (p < 0.001) was demonstrated. There was a significant correlation between anterior shift of SVA and failure to improve SL (p = 0.046). Moreover, anterior SVA shift correlated with increased values of ODI score both 1 and 5 years postoperatively. In low-PI group, failure to correct LL correlated with high ODI scores 5 years postoperatively (r = - 0.499, p = 0.005). CONCLUSIONS: Failure to correct segmental lordosis during surgery for one-level degenerative spondylolisthesis resulted in anterior displacement of the center of gravity, which in turn correlated with unfavorable clinical outcome 1 and 5 years postoperatively. In patients with low PI, failure to maintain lumbar lordosis correlated with unfavorable clinical outcome 5 years after surgery. LEVEL OF EVIDENCE: II. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: The present study aimed to determine whether obtaining adequate lumbar (LL) or segmental (SL) lordosis during instrumented TLIF for one-level degenerative spondylolisthesis affects midterm clinical outcome. METHODS: The study was designed as a prospective one, including 57 patients who underwent single-level TLIF surgery for degenerative spondylolisthesis. Patients were analyzed globally with additional subgroup analysis according to pelvic incidence (PI). Radiographic analysis of spinopelvic sagittal parameters was conducted pre- and postoperatively. Clinical examination including ODI score was performed preoperatively, 1 and 5 years postoperatively. RESULTS: Significant improvement in ODI scores at 1 and 5 years postoperatively (p < 0.001) was demonstrated. There was a significant correlation between anterior shift of SVA and failure to improve SL (p = 0.046). Moreover, anterior SVA shift correlated with increased values of ODI score both 1 and 5 years postoperatively. In low-PI group, failure to correct LL correlated with high ODI scores 5 years postoperatively (r = - 0.499, p = 0.005). CONCLUSIONS: Failure to correct segmental lordosis during surgery for one-level degenerative spondylolisthesis resulted in anterior displacement of the center of gravity, which in turn correlated with unfavorable clinical outcome 1 and 5 years postoperatively. In patients with low PI, failure to maintain lumbar lordosis correlated with unfavorable clinical outcome 5 years after surgery. LEVEL OF EVIDENCE: II. These slides can be retrieved under Electronic Supplementary Material.
Authors: S C Humphreys; S D Hodges; A G Patwardhan; J C Eck; R B Murphy; L A Covington Journal: Spine (Phila Pa 1976) Date: 2001-03-01 Impact factor: 3.468
Authors: J Y Lazennec; S Ramaré; N Arafati; C G Laudet; M Gorin; B Roger; S Hansen; G Saillant; L Maurs; R Trabelsi Journal: Eur Spine J Date: 2000-02 Impact factor: 3.134