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Comparison of Segmental Lordosis and Global Spinopelvic Alignment After Single-Level Lateral Lumbar Interbody Fusion or Transforaminal Lumbar Interbody Fusion.

Abstract：

BACKGROUND:Lateral lumbar interbody fusion (LLIF) has steadily increased in popularity. Compared with the traditional transforaminal lumbar interbody fusion (TLIF), LLIF is thought to allow for greater improvement in lordosis. However, there are limited direct comparison data on the degree of regional and global alignment change after single-level LLIF and TLIF procedures. This study compared the changes in spinal sagittal alignment in patients who underwent either procedure. METHODS:A retrospective analysis of patients who underwent LLIF or TLIF for lumbar degenerative disease at a single institution was performed. Twenty patients who underwent single-level LLIF were matched to 20 patients who underwent single-level TLIF by gender and level of interbody fusion. All included patients had preoperative and postoperative standing scoliosis radiographs. Changes in segmental lordosis (SL) at the fused level, lumbar lordosis (LL), sagittal vertical axis, and pelvic incidence-LL mismatch (PI-LL) were measured. Statistical analysis was performed using paired and unpaired Student's t-tests. Means were reported with standard error. RESULTS:Within each group, 2, 4, and 14 patients had cages placed at L2-3, L3-4, and L4-5, respectively. The LLIF group demonstrated significantly increased SL compared with the TLIF group (+4.9° ± 3.0 vs. +2.6° ± 1.7, P = 0.01). LL, sagittal vertical axis, and PI-LL changes did not differ significantly between groups. CONCLUSIONS:LLIF achieved greater improvements in SL than TLIF. However, regionally and globally, there were no significant differences with either procedure after a single-level intervention. The increased lordosis from LLIF compared with TLIF may be more impactful globally in multilevel fusions.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Saadeh YS,Joseph JR,Smith BW,Kirsch MJ,Sabbagh AM,Park P

doi

10.1016/j.wneu.2019.03.106

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

e1374-e1378

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)30774-0

journal_volume

126

pub_type

杂志文章

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Comparison of Segmental Lordosis and Global Spinopelvic Alignment After Single-Level Lateral Lumbar Interbody Fusion or Transforaminal Lumbar Interbody Fusion.