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Effect of lumbar laminectomy on spinal sagittal alignment: a systematic review – Lumbar Spinal Stenosis

The article discusses the relationship between lumbar spinal stenosis and spinal sagittal alignment, as well as the effect of lumbar decompressive surgery on this alignment. The researchers conducted a systematic review of relevant studies and found that decompression surgery had a small but statistically significant effect on lumbar lordosis, sagittal vertical axis, and pelvic tilt. However, the clinical significance of these changes is likely to be insignificant. The study highlights the need for further research in this area to better understand the impact of decompressive surgery on spinal alignment

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: It appears that decompression may have a small, statistically significant but probably clinically insignificant effect on lumbar lordosis, sagittal vertical axis and pelvic tilt.

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Eur Spine J. 2021 Sep;30(9):2413-2426. doi: 10.1007/s00586-021-06827-y. Epub 2021 Apr 12.ABSTRACTPURPOSE: Positive spinal sagittal alignment is known to correlate with pain and disability. The association between lumbar spinal stenosis and spinal sagittal alignment is less known, as is the effect of lumbar decompressive surgery on the change in that alignment. The objective was to study,

Eur Spine J. 2021 Sep;30(9):2413-2426. doi: 10.1007/s00586-021-06827-y. Epub 2021 Apr 12.

ABSTRACT

PURPOSE: Positive spinal sagittal alignment is known to correlate with pain and disability. The association between lumbar spinal stenosis and spinal sagittal alignment is less known, as is the effect of lumbar decompressive surgery on the change in that alignment. The objective was to study the evidence on the effect of lumbar decompressive surgery on sagittal spinopelvic alignment.

METHODS: The Cochrane Controlled Trials Register (CENTRAL), Medline, Embase, Scopus and Web of Science databases were searched in October 2019, unrestricted by date of publication. The study selection was performed by two independent reviewers. The risk of systematic bias was assessed according to the NIH Quality Assessment Tool. The data were extracted using a pre-defined standardized form.

RESULTS: The search resulted in 807 records. Of these, 18 were considered relevant for the qualitative analysis and 15 for the meta-synthesis. The sample size varied from 21 to 89 and the average age was around 70 years. Decompression was mostly performed on one or two levels and the surgical techniques varied widely. The pooled effect sizes were most statistically significant but small. For lumbar lordosis, the effect size was 3.0 (95% CI 2.2 to 3.7) degrees. Respectively, for pelvic tilt and sagittal vertical axis, the effect sizes were – 1.6 (95% CI .2.6 to – 0.5) degrees and – 9.6 (95% CI – 16.0 to – 3.3) mm.

CONCLUSIONS: It appears that decompression may have a small, statistically significant but probably clinically insignificant effect on lumbar lordosis, sagittal vertical axis and pelvic tilt.

PMID:33844059 | DOI:10.1007/s00586-021-06827-y

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Effect of lumbar laminectomy on spinal sagittal alignment: a systematic review

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Eur Spine J. 2021 Sep;30(9):2413-2426. doi: 10.1007/s00586-021-06827-y. Epub 2021 Apr 12.ABSTRACTPURPOSE: Positive spinal sagittal alignment is known to correlate with pain and disability. The association between lumbar spinal stenosis and spinal sagittal alignment is less known, as is the effect of lumbar decompressive surgery on the change in that alignment. The objective was to study

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