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Predicting Adequate Segmental Lordosis Correction In Lumbar Spinal Stenosis Patients Undergoing Oblique Lumbar Interbody Fusion: A Focus On The Discontinuous Segment London Spine Lumbar Stenosis

The article evaluates factors associated with correction of the segmental angle (SA) following minimally invasive oblique lumbar interbody fusion (MIS-OLIF). The study included patients with lumbar spinal stenosis who underwent single- or two-level MIS-OLIF. Segments with a greater than 10° change in SA after surgery were categorized as discontinuous segments. Results showed that preoperative kyphotic SA and facet effusion were significant predictors for SA correction. Patients with lordotic SA and no facet effusion may require additional procedures for lumbar lordosis correction after MIS-OLIF. Key terms include discontinuous segment, facet effusion, lumbar spinal stenosis, oblique lumbar interbody fusion, sagittal imbalance, and segmental correction

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

Published article

Preoperative kyphotic SA and facet effusion can predict SA correction >10° following MIS-OLIF. For patients with lordotic SA and no preoperative facet effusion, supplemental procedures, such as anterior column release or posterior osteotomy, should be prepared for additional lumbar lordosis correction required for remnant global sagittal imbalance after MIS-OLIF.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Purpose: To identify the factors associated with a correction of the segmental angle (SA) with a total change greater than 10° in each level following minimally invasive oblique lumbar interbody fusion (MIS-OLIF). Methods: Patients with lumbar spinal stenosis who underwent single- or two-level MIS-OLIF were reviewed. Segments with adequate correction of the SA >10°,

Abstract

Purpose: To identify the factors associated with a correction of the segmental angle (SA) with a total change greater than 10° in each level following minimally invasive oblique lumbar interbody fusion (MIS-OLIF).

Methods: Patients with lumbar spinal stenosis who underwent single- or two-level MIS-OLIF were reviewed. Segments with adequate correction of the SA >10° after MIS-OLIF in immediate postoperative radiograph were categorized as discontinuous segments (D segments), whereas those without such improvement were assigned as continuous segments (C segments). Clinical and radiological parameters were compared, and multivariate logistic regression analysis was performed to identify factors associated with SA correction >10° after MIS-OLIF.

Results: Of 211 segments included, 38 segments (18.0%) were classified as D segments. Compared with C segments, D segments demonstrated a significantly smaller preoperative SA (mean ± standard deviation [SD]- 1.1° ± 6.7° vs. 6.6° ± 6.3°, p < 0.001), larger change of SA (mean ± SD, 13.5° ± 3.4° vs. 3.1° ± 3.9°, p < 0.001), and a higher rate of presence of facet effusion (76.3% vs. 48.6%, p = 0.002). Logistic regression revealed preoperative SA (odds ratio (OR) [95% confidence interval (CI)]:0.733 [0.639-0.840]p < 0.001) and facet effusion (OR [95% CI]:14.054 [1.758-112.377], p = 0.027) as significant predictors for >10° SA correction after MIS-OLIF.

Preoperative kyphotic SA and facet effusion can predict SA correction >10° following MIS-OLIF. For patients with lordotic SA and no preoperative facet effusion, supplemental procedures, such as anterior column release or posterior osteotomy, should be prepared for additional lumbar lordosis correction required for remnant global sagittal imbalance after MIS-OLIF.

Keywords: Discontinuous segment; Facet effusion; Lumbar spinal stenosis; Oblique lumbar interbody fusion; Sagittal imbalance; Segmental correction.

The London Spine Unit : most experienced spinal centre in London

Read the original publication:

Predicting adequate segmental lordosis correction in lumbar spinal stenosis patients undergoing oblique lumbar interbody fusion: a focus on the discontinuous segment

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Abstract Purpose: To identify the factors associated with a correction of the segmental angle (SA) with a total change greater than 10° in each level following minimally invasive oblique lumbar interbody fusion (MIS-OLIF). Methods: Patients with lumbar spinal stenosis who underwent single- or two-level MIS-OLIF were reviewed. Segments with adequate correction of the SA >10°

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