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Mid-term results of single-level posterior lumbar interbody fusion in patients with pelvic incidence minus lumbar lordosis mismatch – Lumbar Fusion

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The article investigates the impact of pelvic incidence minus lumbar lordosis (PI-LL) mismatch on the outcomes and reoperation rate after single-level posterior lumbar interbody fusion (PLIF). The study includes 253 patients who underwent L4-5 single-segment PLIF, and they were divided into two groups based on the presence or absence of PI-LL mismatch. The results showed that there were no significant differences in the Japanese Orthopaedic Association (JOA) recovery scores and reoperation rates between the two groups. However, radiographic parameters were worse in the group with PI-LL mismatch. This study suggests that PI-LL mismatch may not significantly affect the mid-term outcomes of single-level PLIF

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spinal centre in the world

Published article

S: The mid-term results of L4-5 single-level PLIF were compared with and without PI-LL mismatch, with the threshold defined as 30°; however, there were no significant differences in both the JOA recovery and reoperation rates between the two groups.

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World Neurosurg. 2024 Jan 11:S1878-8750(24)00043-3. doi: 10.1016/j.wneu.2024.01.031. Online ahead of print.ABSTRACTBACKGROUND: Recent literature suggests that sagittal imbalance is a risk factor for adjacent segment disease (ASD) following fusion surgery. This study explored the influence of pelvic incidence minus lumbar lordosis (PI-LL) mismatch on the mid-term results and reoperation rate after single-level posterior lumbar interbody fusion,

World Neurosurg. 2024 Jan 11:S1878-8750(24)00043-3. doi: 10.1016/j.wneu.2024.01.031. Online ahead of print.

ABSTRACT

BACKGROUND: Recent literature suggests that sagittal imbalance is a risk factor for adjacent segment disease (ASD) following fusion surgery. This study explored the influence of pelvic incidence minus lumbar lordosis (PI-LL) mismatch on the mid-term results and reoperation rate after single-level posterior lumbar interbody fusion (PLIF).

METHODS: The participants of this study included 253 patients (80 men and 173 women; mean age 68.2 years) who underwent L4-5 single-segment PLIF. Preoperative PI-LL mismatch was defined as a PI-LL of 30° or greater. The patients were divided into two groups according to the presence or absence of PI-LL mismatch (PI-LL mismatch group; group M, Control group; group C), and the clinical outcomes and radiographic parameters were compared.

RESULTS: Of the 253 cases, 25 were classified in group M and 228 in group C. The Japanese Orthopaedic Association (JOA) score at five years postoperatively was 23.0±3.6 in group M and 23.5±5.1 in group C, and the recovery rate was 66.2±32.6% in group M and 64.6±21.4% in group C and there was no significant difference in the recovery rate between the two groups. All radiographic parameters except SS were significantly worse in group M. One patient (4.3%) in Group M and 18 patients (7.8%) in Group C required revision surgery at 2.4 years (range 0.0-5.0) and there was no significant difference in the revision rate between the two groups.

S: The mid-term results of L4-5 single-level PLIF were compared with and without PI-LL mismatch, with the threshold defined as 30°; however, there were no significant differences in both the JOA recovery and reoperation rates between the two groups.

PMID:38218438 | DOI:10.1016/j.wneu.2024.01.031

The London Spine Unit : most specialised spinal centre in the world

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Mid-term results of single-level posterior lumbar interbody fusion in patients with pelvic incidence minus lumbar lordosis mismatch

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World Neurosurg. 2024 Jan 11:S1878-8750(24)00043-3. doi: 10.1016/j.wneu.2024.01.031. Online ahead of print.ABSTRACTBACKGROUND: Recent literature suggests that sagittal imbalance is a risk factor for adjacent segment disease (ASD) following fusion surgery. This study explored the influence of pelvic incidence minus lumbar lordosis (PI-LL) mismatch on the mid-term results and reoperation rate after single-level posterior lumbar interbody fusion

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