ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Association of operative-level segmental lordosis correction with reciprocal changes in sagittal and spinopelvic parameters after single-level lateral lumbar interbody fusion at L4-5.
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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeAssess the relationship between change in L4-5 segmental lordosis (SL) and its effect on clinical and radiographic parameters after lateral lumbar interbody fusion (LLIF) at L4-5.
methodsClinical scores and radiographic measurements were collected for patients who underwent single-level LLIF at L4-5 at a local institution between 2017 and 2022. Linear regression analysis was performed for changes in clinical and radiographic parameters as a function of change in SL.
resultsNinety-four patients were included in the analysis. Significant preoperative to postoperative increases occurred in L4-5 SL (P < 0.001), L2-3 SL (P = 0.04), anterior disc height (P < 0.001), posterior disc height (P < 0.001), neural foraminal height (P < 0.001), and T1-pelvic angle (P = 0.03). Significant decreases occurred postoperatively in L5-S1 SL (P < 0.001) and spondylolisthesis length (P < 0.001). Change in L4-5 SL was positively correlated with Δ lumbar lordosis (LL; P = 0.001), Δ distal LL (P < 0.001), Δ anterior disc height (P < 0.001), and Δ T5-T12 kyphosis (P = 0.04). Change in L4-5 SL was negatively correlated with Δ pelvic incidence-LL mismatch (P = 0.001) and Δ L5-S1 SL (P = 0.01).
conclusionLLIF at L4-5 induced greater L4-5 SL; this change was positively associated with changes in LL, distal LL, anterior disc height, and T5-T12 kyphosis, and negatively associated with changes in pelvic incidence-LL mismatch and L5-S1 SL. Potential compensatory changes proximal and distal to the LLIF level may depend on the amount of SL achieved at the operative level.
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