Evidence map›Paper›PMID 33409727›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021

Preoperative lordosis in L4/5 predicts segmental lordosis correction achievable by transforaminal lumbar interbody fusion.

Clara Berlin, Ferdinand Zang, Henry Halm, Markus Quante

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Radiographic and surgery-related predictive factors for increased segmental lumbar lordosis following lumbar fusion surgery in patients with degenerative lumbar spondylolisthesis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024
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  3. Article
  4. Article
  5. Article
4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Clara BerlinSpine Surgery With Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23552, Neustadt in Holstein, Germany. cberlin@schoen-klinik.de.ORCID http://orcid.org/0000-0002-1235-6413
Ferdinand ZangSpine Surgery With Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23552, Neustadt in Holstein, Germany.
Henry HalmSpine Surgery With Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23552, Neustadt in Holstein, Germany.
Markus QuanteSpine Surgery With Scoliosis Center, Schön Klinik Neustadt, Am Kiebitzberg 10, 23552, Neustadt in Holstein, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe mean potential of lordosis restoration by transforaminal lumbar interbody fusion (TLIF) is supposed to be low in general. In contrast, clinical experience shows a wide range of segmental lordosis correction. In this study, the predictability of lordosis correction should be investigated.

methodsProspectively collected register data were analyzed retrospectively. One hundred twenty-one consecutive patients (2014-2016) operated with single-level TLIF L4/5 (10°-lordotic cage). Segmental lordosis (L4/5) and overall lordosis (L1-S1) were measured on lumbar X-rays: preoperatively (pre), after 3-5 days (post), at least 24 months postoperatively (2yFU). Outcome and satisfaction of patients were assessed. Parameters were statistically compared by students t-tests (a = 0.05). In addition, predictors of correction were analyzed.

resultsAge was 60.7 years, rate of 2yFU 41.3% (n = 50). Lordosis correction L4/5 was statistically significant with (post-pre) 4.9 ± 5.7° (p < 0.01), but not significant for L1-S1 (post-pre) 1.6 ± 8.0° (p = 0.3). A strong-moderate correlation of lordosis L4/5 (pre) and lordosis correction L4/5 (post-pre) was shown (r =  - 0.6, p < 0,01). In a rising range of preoperative lordosis L4/5 from 15-30° the likelihood of lordosis loss increased. In 2yFU correction, L4/5 was significant with (post-pre) 5.4 ± 5.4° (p < 0.01), no significant long-term change (2yFU-postop)  - 1.5 ± 4.9° (p = 0.2). No correlation (r =  - 0.1) of correction and ODI. VAS-B improved by means of 2.9, VAS-L by 2.5, ODI by 19.1% (pre vs. 2yFU), each statistically significant (p < 0.01).

conclusionSignificant segmental relordosation can be performed by TLIF L4/5. The potential of correction strongly correlates with preoperative lordosis. Therefore, TLIF technique should be considered carefully in cases with a preoperative segmental lordosis of more than 15° and additional need of lordosation.

Indexed as

LordosisSpinal FusionHumansLumbar VertebraeLumbosacral RegionMiddle AgedRetrospective StudiesTreatment OutcomeDegenerative disk diseaseDegenerative spondylolisthesisLordosis correctionLumbar spineTLIF

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.