ArticleOrthopaedic surgery2025
Impact of Sagittal Spinal Balance on Functional Recovery After PLIF of L5-S1 Isthmic Spondylolisthesis With Lumbar Spinal Stenosis.
Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Sagittal Alignment as a Determinant of Pain and Functional Recovery after Lumbar Surgery: A Systematic Review and Meta-Analysis.Spine surgery and related research · 2026Review
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10 authors.
Funding
Abstract
objectiveDespite the widespread use of posterior lumbar interbody fusion (PLIF) for L5-S1 isthmic spondylolisthesis (IS) with lumbar spinal stenosis (LSS), residual sagittal imbalance critically impairs long-term pain relief and functional recovery. This study analyzes the influence of residual sagittal imbalanceon health-related quality of life (HRQOL) after PLIF for L5-S1 IS with LSS, aiming to optimize surgical correction and prognostic accuracy.
methodsThis study analyzed 103 consecutive patients with L5-S1 IS and LSS undergoing PLIF from 2020 to 2022, followed at 3 days, 3 months, and ≥ 1 year postoperatively, using SPSS 26.0 for statistical analysis. Preoperatively, patients were stratified into balanced (SVA ≤ 50 mm) and unbalanced (SVA > 50 mm) groups. Postoperatively, the unbalanced group was reclassified into postoperative balanced (SVA ≤ 50 mm) and postoperative unbalanced (SVA > 50 mm) groups. Spinal parameters-including SVA, slip degree (SD), disc height (HOD), lumbar lordosis (LL), pelvic tilt (PT), and pelvic incidence (PI)-and clinical outcomes (Oswestry Disability Index [ODI], Visual Analogue Scale [VAS]) were analyzed preoperatively and postoperatively to assess surgical efficacy. Postoperative unbalanced group.
resultsIn the balanced and unbalanced groups, SD and HOD significantly improved postoperatively versus preoperative values (p < 0.05). The balanced group showed no postoperative changes in SVA, LL, or PT (p > 0.05), while the unbalanced group exhibited marked improvements in these parameters (p < 0.05). At final follow-up, the balanced group maintained superior SVA, SD, HOD, LL, and PT compared to the unbalanced group (p < 0.05). Among the unbalanced group, postoperative balanced and unbalanced groups demonstrated significant improvements in SVA, SD, HOD, and PT (p < 0.05). However, LL remained unchanged in the postoperative unbalanced group (p > 0.05), whereas it improved in the postoperative balanced group (p < 0.05). The postoperative balanced group also achieved better SVA, SD, HOD, LL, and PT outcomes versus the postoperative unbalanced group (p < 0.05). ODI and VAS scores improved across all groups postoperatively, with the balanced group and postoperative balanced group outperforming their counterparts at final follow-up (p < 0.05).
conclusionPreoperative and postoperative sagittal balance are pivotal determinants of long-term functional recovery and HRQOL in patients undergoing PLIF for L5-S1 IS with LSS.
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