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Predictors of Postoperative Segmental and Overall Lumbar Lordosis in Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Consecutive Case Series – Lumbar Fusion

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The article is a retrospective case-series that aims to determine the effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) on postoperative segmental lordosis (SL) and lumbar lordosis (LL). The study involved patients who underwent single-level MI-TLIF for grade 1 degenerative spondylolisthesis. Radiographic factors associated with lordosis after surgery were identified, and predictors of change in SL/LL were evaluated. The results showed that the majority of patients experienced lordosing or neutral MI-TLIFs, and preoperative radiographic alignment and anterior cage placement were significantly associated with target SL following MI-TLIF. Overall, patients experienced improvements in functional outcomes and low-back pain after surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised sugical centre on Harley Street UK

Published article

CONCLUSIONS: In our series, the majority of patients experienced lordosing or neutral MI-TLIFs (n = 69, 95%). Preoperative radiographic alignment and anterior cage placement were significantly associated with target SL following MI-TLIF.

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Global Spine J. 2023 Jul 31:21925682231193610. doi: 10.1177/21925682231193610. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective Case-Series.OBJECTIVES: Due to heterogeneity in previous studies, the effect of MI-TLIF on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Therefore, we aim to identify radiographic factors associated with lordosis after surgery in a homogenous series of MI-TLIF patients.METHODS:,

Global Spine J. 2023 Jul 31:21925682231193610. doi: 10.1177/21925682231193610. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective Case-Series.

OBJECTIVES: Due to heterogeneity in previous studies, the effect of MI-TLIF on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Therefore, we aim to identify radiographic factors associated with lordosis after surgery in a homogenous series of MI-TLIF patients.

METHODS: A single-center retrospective review identified consecutive patients who underwent single-level MI-TLIF for grade 1 degenerative spondylolisthesis from 2015-2020. All surgeries underwent unilateral facetectomies and a contralateral facet release with expandable interbody cages. PROs included the ODI and NRS-BP for low-back pain. Radiographic measures included SL, disc height, percent spondylolisthesis, cage positioning, LL, PI-LL mismatch, sacral-slope, and pelvic-tilt. Surgeries were considered “lordosing” if the change in postoperative SL was ≥ +4° and “kyphosing” if ≤ -4°. Predictors of change in SL/LL were evaluated using Pearson’s correlation and multivariable regression.

RESULTS: A total of 73 patients with an average follow-up of 22.5 (range 12-61) months were included. Patients experienced significant improvements in ODI (29% ± 22% improvement, P < .001) and NRS-BP (3.3 ± 3 point improvement, P < .001). There was a significant increase in mean SL (Δ3.43° ± 4.37°, P < .001) while LL (Δ0.17° ± 6.98°, P > .05) remained stable. Thirty-eight (52%) patients experienced lordosing MI-TLIFs, compared to 4 (5%) kyphosing and 31 (43%) neutral MI-TLIFs. A lower preoperative SL and more anterior cage placement were associated with the greatest improvement in SL (β = -.45° P = .001, β = 15.06° P < .001, respectively).

CONCLUSIONS: In our series, the majority of patients experienced lordosing or neutral MI-TLIFs (n = 69, 95%). Preoperative radiographic alignment and anterior cage placement were significantly associated with target SL following MI-TLIF.

PMID:37522797 | DOI:10.1177/21925682231193610

The London Spine Unit : best recognised sugical centre on Harley Street UK

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Predictors of Postoperative Segmental and Overall Lumbar Lordosis in Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Consecutive Case Series

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Global Spine J. 2023 Jul 31:21925682231193610. doi: 10.1177/21925682231193610. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective Case-Series.OBJECTIVES: Due to heterogeneity in previous studies, the effect of MI-TLIF on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Therefore, we aim to identify radiographic factors associated with lordosis after surgery in a homogenous series of MI-TLIF patients.METHODS:
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