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Preoperative and Postoperative Segmental and Overall Range of Motion in Patients Undergoing Lumbar Spinal Fusion Using HA-Infused PEEK and HA-Treated Titanium Alloy Interbody Cages – Lumbar Fusion

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The article is a retrospective observational radiographic analysis that aimed to determine how single-level lumbar interbody fusion (LIF) affects the range of motion (ROM) at adjacent levels and overall ROM. The study included 54 patients who underwent different types of LIF procedures, and segmental ROM and overall lumbar ROM were assessed preoperatively and postoperatively. The results showed that after the LIF procedure, overall lumbar ROM decreased by 14%, ROM at the fusion level decreased by 77%, caudal adjacent segment ROM decreased by 12%, and cranial ROM increased by 34%. Cluster analysis identified three distinct clusters of patients with different relative changes in ROM and patient-reported outcomes measures (PROMs). The study concluded that patients should expect a loss of 3.3° or 14% of overall lumbar motion after single-level LIF, with variability based on individual patient characteristics

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : the highest rated treatment facility in London

Published article

: Following single-level L IF, patients should expect a loss of 3.3°, or 14% of overall lumbar motion with increases in ROM of the cranial segment. However, specific clusters of patients exist that experience different relative changes in ROM and PROMs.

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Global Spine J. 2023 Dec 20:21925682231223117. doi: 10.1177/21925682231223117. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective observational radiographic analysis.OBJECTIVE: Determine how single level lumbar interbody fusion (LIF) alters segmental range of motion (ROM) at adjacent levels and decreases overall ROM.METHODS: This study included 54 patients who underwent single-level anterior (ALIF, 39%), thoraco-LIF (TLIF, 26%), posterior LIF (PLIF,

Global Spine J. 2023 Dec 20:21925682231223117. doi: 10.1177/21925682231223117. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective observational radiographic analysis.

OBJECTIVE: Determine how single level lumbar interbody fusion (LIF) alters segmental range of motion (ROM) at adjacent levels and decreases overall ROM.

METHODS: This study included 54 patients who underwent single-level anterior (ALIF, 39%), thoraco-LIF (TLIF, 26%), posterior LIF (PLIF, 22%), or lateral LIF (LLIF, 13%) (L2-3/L3-4/L4-5/L5-S1: 4%/13%/35%/48%). Segmental ROM from L1-2 to L5-S1 and the overall lumbar ROM (L1-S1) were assessed from preoperative and postoperative flexion-extension radiographs. K-means cluster analysis was used to identify ROM subgroups.

RESULTS: The overall L1-S1 ROM decreased 14% (25.5 ± 20.4° to 22.0 ± 17.2°, P = .104) postoperatively. ROM at the fusion level decreased 77% (4.8 ± 5.0° to 1.1 ± 1.1°, P < .001). Caudal adjacent segment ROM decreased 12% (5.2 ± 5.7° to 4.6 ± 4.4°, P = .345) and cranially ROM increased 34% (4.3 ± 5.0° to 5.7 ± 5.7°, P = .05). K-cluster analysis identified 3 distinct clusters (P < .05). Cluster 1 lost more ROM and had less improvement in patient-reported outcomes measures (PROMs) than average. Cluster 2 had less ROM loss than average with worse PROMs improvement. Cluster 3 did not have changes in ROM and better improvement in PROMs than average. Successful fusion was verified in 96% of all instrumented segments with >6 months follow-up (ROM <4°).

: Following single-level L IF, patients should expect a loss of 3.3°, or 14% of overall lumbar motion with increases in ROM of the cranial segment. However, specific clusters of patients exist that experience different relative changes in ROM and PROMs.

PMID:38116633 | DOI:10.1177/21925682231223117

The London Spine Unit : the highest rated treatment facility in London

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Preoperative and Postoperative Segmental and Overall Range of Motion in Patients Undergoing Lumbar Spinal Fusion Using HA-Infused PEEK and HA-Treated Titanium Alloy Interbody Cages

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Global Spine J. 2023 Dec 20:21925682231223117. doi: 10.1177/21925682231223117. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective observational radiographic analysis.OBJECTIVE: Determine how single level lumbar interbody fusion (LIF) alters segmental range of motion (ROM) at adjacent levels and decreases overall ROM.METHODS: This study included 54 patients who underwent single-level anterior (ALIF, 39%), thoraco-LIF (TLIF, 26%), posterior LIF (PLIF

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