Preoperative Radiographic Prediction Tool for Early Postoperative Segmental and Lumbar Lordosis Alignment After Transforaminal Lumbar Interbody Fusion

التفاصيل البيبلوغرافية
العنوان: Preoperative Radiographic Prediction Tool for Early Postoperative Segmental and Lumbar Lordosis Alignment After Transforaminal Lumbar Interbody Fusion
المؤلفون: Rachel Moor, Paul Kubilis, Ken Porche, Daniel J. Hoh, Alexander B. Dru, Sasha Vaziri
المصدر: Cureus
بيانات النشر: Cureus, Inc., 2021.
سنة النشر: 2021
مصطلحات موضوعية: medicine.diagnostic_test, Lordosis, business.industry, Radiography, Neurosurgery, General Engineering, Pelvic incidence, Magnetic resonance imaging, posterior lumbar interbody fusion, medicine.disease, lordosis, Facetectomies, Single surgeon, radiographic outcomes, Lumbar interbody fusion, transforaminal lumbar interbody fusion, medicine, sense organs, Radiology, lumbar spine fusion, business, Nuclear medicine, Lumbar lordosis
الوصف: Objective Transforaminal lumbar interbody fusion (TLIF) is a common approach and results in varying degrees of lordosis correction. The purpose of this study is to determine preoperative radiographic spinopelvic parameters that predict change in postoperative segmental and lumbar lordosis after TLIF. Materials & Methods This study is a single surgeon retrospective review of one-level and two-level TLIFs from L3-S1. All patients underwent bilateral facetectomies, 10 mm TLIF cage (non-lordotic) insertions, and bilateral pedicle screw-rod construct placements. Pre- and post-operative X-rays were assessed for preoperative segmental lordosis (SL), lumbar lordosis (LL), and pelvic incidence (PI). Univariate and multi-predictor linear regression analyses were performed to determine the relationships between preoperative radiographic findings and change in early postoperative segmental and lumbar lordosis. Results Ninety-seven patients contributing 128 intervertebral segments were examined. The mean change in SL after TLIF was 7.3 (range: 0.10-28.9°, SD 6.39°). The mean change in LL after TLIF was 5.5˚ (range: -14.8-39.2°, standard deviation (SD) 7.16°). Greater preoperative LL predicted less postoperative LL correction, while greater preoperative PI predicted more postoperative SL and LL correction. Greater anterior disk height was noted to be associated with a decreased change in SL (∆SL). An annular tear on preoperative magnetic resonance imaging (MRI) predicted a 2.7° decrease in ∆SL. A Schmorl's node on preoperative MRI predicted a 4.0° decrease in change in LL (∆LL). Conclusions A greater preoperative lordosis and a lower spinopelvic mismatch lessen the potential for an increase in the postoperative SL and LL after a TLIF, which is likely due to a ‘ceiling’ effect of an otherwise optimized spinal alignment. A greater anterior disk height and the presence of an annular tear are associated with decreased ∆SL.
تدمد: 2168-8184
DOI: 10.7759/cureus.18175
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::36dc33ed09e85337f180424475d77dd4
https://doi.org/10.7759/cureus.18175
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....36dc33ed09e85337f180424475d77dd4
قاعدة البيانات: OpenAIRE
الوصف
تدمد:21688184
DOI:10.7759/cureus.18175