ArticleJournal of spine surgery (Hong Kong)2020
Restoring spinopelvic harmony with lateral lumbar interbody fusion: is it a realistic goal?
Article in Journal of spine surgery (Hong Kong), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Effects of preoperative sagittal spinal imbalance on pain after lateral lumbar interbody fusion.Scientific reports · 2022Article
- Variation in Sagittal Alignment Parameters in Adult Patients before Spine Surgery: A Serial Imaging Study Using Antero-Posterior and Latero-Lateral Projections.Diagnostics (Basel, Switzerland) · 2021Article
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Authors and funding
6 authors.
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Abstract
backgroundThe importance of spinopelvic harmony [pelvic incidence (PI) = lumbar lordosis (LL) ±10 degrees] is well established in the literature. We aimed to determine whether lateral lumbar interbody fusion (LLIF) surgery in isolation is successful in restoring spinopelvic harmony, and whether the surgery maintained the relationship in those who present in a balanced state.
methodsA retrospective radiographic analysis was performed on patients who underwent LLIF surgery, followed by posterior instrumented fusion, between January 2012 to August 2019 by a single surgeon (AD). Pre- and post-operative X-rays were reviewed by two authors using Surgimap spinal imaging 2.2.15.5. The LL, PI, and PI-LL mismatch, as well as a range of coronal and segmental sagittal radiographic parameters, were recorded.
resultsA total of 71 patients with 170 levels treated via LLIF were analysed. A mean pre-operative PI-LL of 14.3 degrees and post-operative value of 13.4 degrees was recorded (P=0.43). Of the 41 patients who were imbalanced pre-operatively, 13 (31.7%) were restored to a LL within 10 degrees of PI post-LLIF procedure. 30 patients presented in spinopelvic harmony, and 25 (83.3%) of those maintained that relationship following LLIF. Mean coronal global Cobb angles (13.7 degrees pre-operatively to 7.7 degrees post-operatively), segmental coronal Cobb angles (3.8 to 0.9 degrees), and anterior (5.2 to 9.8 mm) and posterior (3.2 to 6.7 mm) disc heights all improved significantly post-LLIF surgery (P<0.0001).
conclusionsAlthough an effective treatment for coronal deformities and providing indirect decompression for degenerative lumbar disc disease, LLIF surgery alone is unlikely to result in correction of sagittal deformity and in particular spinopelvic harmony.
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