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Postoperative lordosis distribution index, patient reported outcome measures, and revision surgery following transforaminal lumbar interbody fusion – Lumbar Fusion

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The article published in World Neurosurgery X explores the correlation between Lordosis Distribution Index (LDI) and postoperative outcomes in patients undergoing Transforaminal Lumbar Interbody Fusion (TLIF) surgery. The study, conducted at a Danish university hospital, analyzed data from 126 patients who underwent TLIF surgery in 2017. The primary outcome measured was Oswestry Disability Index (ODI) at 12 months postoperatively. Secondary outcomes included revision rate and additional Patient Related Outcome Measures (PROMs). The results showed no significant correlation between LDI subgroups (normolordotic, hypo-, and hyperlordotic) and the clinical outcomes of TLIF surgery, although there was a trend towards a lower revision surgery rate in the normolordotic group

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: We found no significant correlation between postoperative LDI subgroups of normolordotic, hypo- or hyperlordotic patients and the clinical outcome of posterolateral fusion and TLIF surgery. A trend towards lower rate of revision surgery in the normolordotic group compared to the hypo- and hyperlordotic group was observed.

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World Neurosurg X. 2023 Dec 12;21:100251. doi: 10.1016/j.wnsx.2023.100251. eCollection 2024 Jan.ABSTRACTOBJECTIVE: Lordosis Distribution Index (LDI) is a new radiographic parameter associated with postoperative residual symptoms in patients undergoing Transforaminal Lumbar Interbody Fusion (TLIF). Recently, it has been applied on patients undergoing instrumented spine surgery, however not correlated to Patient Related Outcome Measures (PROMs). This study,

World Neurosurg X. 2023 Dec 12;21:100251. doi: 10.1016/j.wnsx.2023.100251. eCollection 2024 Jan.

ABSTRACT

OBJECTIVE: Lordosis Distribution Index (LDI) is a new radiographic parameter associated with postoperative residual symptoms in patients undergoing Transforaminal Lumbar Interbody Fusion (TLIF). Recently, it has been applied on patients undergoing instrumented spine surgery, however not correlated to Patient Related Outcome Measures (PROMs). This study investigates whether the obtained the postoperative LDI after TLIF surgery correlates with the clinical outcome measured with PROMs.

METHODS: This study was based on prospectively obtained data in patients undergoing TLIF throughout 2017 at a Danish university hospital. Medical records and the DaneSpine Database were accessed to obtain preoperative, operative and follow-up data. Primary outcome was Oswestry Disability Index (ODI) 12 months postoperatively. Secondary outcomes included revision rate and additional PROMs.

RESULTS: 126 patients were included. 70 patients were classified with normolordosis (56 %), 42 hypolordosis (33 %) and 14 hyperlordosis (11 %). All groups experienced significant radiological changes undergoing surgery. Average reduction in ODI at 12 months postoperatively was -15.3 (±20.0). Minimally clinical important difference was achieved in 68 patients (54.0 %). No significant difference in PROMs between LDI-groups was observed in unadjusted or adjusted analyses. Revision surgery was performed in 8 patients with normolordosis (11.4 %), 7 hypolordosis (16.7 %) and 4 hyperlordosis (28.6 %).

S: We found no significant correlation between postoperative LDI subgroups of normolordotic, hypo- or hyperlordotic patients and the clinical outcome of posterolateral fusion and TLIF surgery. A trend towards lower rate of revision surgery in the normolordotic group compared to the hypo- and hyperlordotic group was observed.

PMID:38173686 | PMC:PMC10762461 | DOI:10.1016/j.wnsx.2023.100251

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Postoperative lordosis distribution index, patient reported outcome measures, and revision surgery following transforaminal lumbar interbody fusion

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World Neurosurg X. 2023 Dec 12;21:100251. doi: 10.1016/j.wnsx.2023.100251. eCollection 2024 Jan.ABSTRACTOBJECTIVE: Lordosis Distribution Index (LDI) is a new radiographic parameter associated with postoperative residual symptoms in patients undergoing Transforaminal Lumbar Interbody Fusion (TLIF). Recently, it has been applied on patients undergoing instrumented spine surgery, however not correlated to Patient Related Outcome Measures (PROMs). This study

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