Ample restoration of disc peak and segmental lordosis by lumbar interbody fusion decreases adjoining phase degeneration.
World Neurosurg. 2018 Jul 18;:
Authors: Tian H, Wu A, Guo M, Zhang Okay, Chen C, Li X, Cheng X, Zhou T, Murray SS, Solar X, Zhao J
OBJECTIVE: This research aimed to analyze the results of lumbar interbody fusion-induced biomechanical adjustments on the adjoining segments, particularly disc peak and segmental lordosis restoration, and supply extra info for correct surgical technique choice.
METHODS: The medical data of 528 sufferers who underwent posterior lumbar interbody fusion have been retrospectively reviewed, and a complete of 89 sufferers have been included. Surgical indications included degenerative spondylolisthesis (non-spondylolytic), marked disc herniation or lumbar spinal stenosis requiring intensive decompression at L4/5. Postoperative ASD was assessed primarily based on X-rays and practical standing. Disc peak, foraminal peak, segmental lordosis, lumbar lordosis and cage geometry have been in contrast between the ASD and Non-ASD sufferers. To determine the doable threat components for radiographic ASD, univariate evaluation was carried out first, adopted by multivariate logistic regression utilizing variables with p<zero.20.
RESULTS: Univariate evaluation revealed that the postoperative disc peak of the Non-ASD group have been considerably better than these of the ASD group. The postoperative segmental lordosis of the Non-ASD group was considerably better than that of the ASD group, and the lumbar lordosis of Non-ASD group was additionally considerably better than that of the ASD group on the last follow-up. 4 variables have been recognized as unbiased threat components for ASD by subsequent multivariate logistic regression: postoperative relative disc peak of L4/5 (p=zero.011), postoperative segmental lordosis (p=zero.046), lumbar lordosis at last observe up (p=zero.007), and cage peak (zero.038).
CONCLUSIONS: Improved lumbar lordosis is correlated with a decrease incidence of ASD, and satisfactory disc peak and segmental lordosis restoration are important for ASD prevention.
PMID: 30031179 [PubMed – as supplied by publisher]