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Distal Lumbar Lordosis is Associated With Reoperation for Adjacent Segment Disease After Lumbar Fusion for Degenerative Conditions – Lumbar Fusion

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The article discusses a single-centre retrospective review that investigated the impact of post-operative distal lumbar lordosis on adjacent segment disease (ASD) requiring reoperation in patients undergoing lumbar fusion for degenerative conditions. The study found that patients with a lower post-operative distal lumbar lordosis had higher odds of reoperation for ASD. The results suggest a potential association between post-operative distal lumbar lordosis and the risk of ASD in patients undergoing lumbar fusions. Further multicentre prospective studies are needed to confirm this association and identify the impact of restoring physiological distal lumbar lordosis on long-term patient outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : the highest rated spine hospital in London

Published article

: This study provides preliminary support to an association between post-operative distal lumbar lordosis and risk of reoperation for ASD in patients undergoing fusions for degenerative conditions. Further multicentre prospective study is needed to independently confirm this association and identify the impact of restoration of physiological distal lumbar lordosis on long term patient outcomes.

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Global Spine J. 2024 Jun 14:21925682241262704. doi: 10.1177/21925682241262704. Online ahead of print. ABSTRACT STUDY DESIGN: A single centre retrospective review. OBJECTIVE: Recent studies have suggested that distal lordosis (L4-S1, DL) remains constant across all pelvic incidence (PI) subgroups, whilst proximal lordosis (L1-L4, PL) varies. We sought to investigate the impact of post-operative DL on adjacent,

Global Spine J. 2024 Jun 14:21925682241262704. doi: 10.1177/21925682241262704. Online ahead of print.

ABSTRACT

STUDY DESIGN: A single centre retrospective review.

OBJECTIVE: Recent studies have suggested that distal lordosis (L4-S1, DL) remains constant across all pelvic incidence (PI) subgroups, whilst proximal lordosis (L1-L4, PL) varies. We sought to investigate the impact of post-operative DL on adjacent segment disease (ASD) requiring reoperation in patients undergoing lumbar fusion for degenerative conditions.

METHODS: Patients undergoing 1-3 level lumbar fusion with the two senior authors between 2007-16 were included. Demographic and radiographic data were recorded. Univariate, multivariate binary logistic regression, and Kaplan Meier survivorship analyses were performed.

RESULTS: 335 patients were included in the final analysis. Most had single (67%) or two (31%) level fusions. The mean follow-up was 64-month. Fifty-seven patients (17%) underwent reoperation for ASD at an average of 78-month post-operatively (R group). The R group had a significantly lower mean post-operative DL (27.3 vs 31.1 deg, P < .001) and mean PI (55.5 vs 59.2 deg, P < .05). On univariate analysis, patients with a post-operative DL of <35 deg had higher odds of reoperation for ASD than those with a post-operative DL of ≥35 deg (OR 2.7, P = .016). In the multivariate model, post-operative DL, low/average PI, and spondylolisthesis were all significantly associated with reoperation for ASD.

: This study provides preliminary support to an association between post-operative distal lumbar lordosis and risk of reoperation for ASD in patients undergoing fusions for degenerative conditions. Further multicentre prospective study is needed to independently confirm this association and identify the impact of restoration of physiological distal lumbar lordosis on long term patient outcomes.

PMID:38874188 | DOI:10.1177/21925682241262704

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Distal Lumbar Lordosis is Associated With Reoperation for Adjacent Segment Disease After Lumbar Fusion for Degenerative Conditions

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Global Spine J. 2024 Jun 14:21925682241262704. doi: 10.1177/21925682241262704. Online ahead of print. ABSTRACT STUDY DESIGN: A single centre retrospective review. OBJECTIVE: Recent studies have suggested that distal lordosis (L4-S1, DL) remains constant across all pelvic incidence (PI) subgroups, whilst proximal lordosis (L1-L4, PL) varies. We sought to investigate the impact of post-operative DL on adjacent

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