Do intraoperative radiographs predict last lumbar sagittal alignment following single-level transforaminal lumbar interbody fusion?

Articles

Do intraoperative radiographs predict last lumbar sagittal alignment following single-level transforaminal lumbar interbody fusion?

J Neurosurg Backbone. 2018 Feb 16;:1-6

Authors: Salem KMI, Eranki AP, Paquette S, Boyd M, Avenue J, Kwon BK, Fisher CG, Dvorak MF

Summary
OBJECTIVE The research aimed to find out if the intraoperative segmental lordosis (as calculated on a cross-table lateral radiograph following a single-level transforaminal lumbar interbody fusion [TLIF] for degenerative spondylolisthesis/low-grade isthmic spondylolisthesis) is maintained at discharge and at 6 months postsurgery. METHODS The authors reviewed pictures and medical information of sufferers ? 16 years of age with a prognosis of an remoted single-level, low-grade spondylolisthesis (degenerative or isthmic) with symptomatic spinal stenosis handled between January 2008 and April 2014. Age, intercourse, surgical degree, surgical strategy, and facetectomy (unilateral vs bilateral) have been recorded. Upright standardized preoperative, early, and 6-month postoperative radiographs, in addition to intraoperative lateral radiographs, have been analyzed for the pelvic incidence, segmental lumbar lordosis (SLL) on the TILF degree, and complete LL (TLL). As well as, the anteroposterior place of the cage within the disc area was documented. Knowledge are offered because the imply ± SD; a p worth < zero.05 was thought-about important. RESULTS Eighty-four sufferers have been included within the research. The imply age of sufferers was 56.eight ± 13.7 years, and 46 sufferers (55%) have been males. The imply pelvic incidence was 59.7° ± 11.9°, and a posterior midline strategy was utilized in 47 circumstances (56%). All TLIF procedures have been single degree utilizing a bullet-shaped cage. A bilateral facetectomy was carried out in 17 sufferers (20.2%), and 89.three% of procedures have been finished on the L4-5 and L5-S1 segments. SLL considerably improved intraoperatively from 15.eight° ± 7.5° to 20.9° ± 7.7°, however the correction was misplaced after ambulation. In contrast with preoperative values, at 6 months the change in SLL was modest at 1.eight° ± 6.7° (p = zero.025), whereas TLL elevated by four.three° ± 9.6° (p < zero.001). The anteroposterior place of the cage, strategy, degree of surgical procedure, and use of a bilateral facetectomy didn’t considerably have an effect on postoperative LL. CONCLUSIONS Following a single-level TLIF process utilizing a bullet-shaped cage, the intraoperative enchancment in SLL is essentially misplaced after ambulation. The advance in TLL over time might be because of the decompression a part of the process. The strategy, degree of surgical procedure, bilateral facetectomy, and place of the cage don’t appear to have a major impact on LL achieved postoperatively.

PMID: 29451437 [PubMed – as supplied by publisher]

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Do intraoperative radiographs predict last lumbar sagittal alignment following single-level transforaminal lumbar interbody fusion? | Artificial disc replacement - spinal surgeries - london spine