19 Harley St, London, W1G 9QJ, UK

Radiographic restoration of lumbar alignment after transforaminal lumbar interbody fusion

OBJECTIVE: Restoration of lumbar lordosis is a critical factor in long-term success after lumbar fusions. Transforaminal lumbar interbody fusion (TLIF) is a popular surgical technique in the lumbar spine, but few data exist on change in spinal alignment after the procedure. METHODS: Eighty patients who underwent TLIF surgery were retrospectively reviewed (minimum follow-up period, 2 years). Standing x-rays were assessed for changes in focal and segmental kyphosis, and restoration of lumbar lordosis. Improvement in spondylolisthesis, sagittal balance, and scoliosis were also assessed. Fusion was assessed as well. RESULTS: Eighty operations were performed at 107 levels. Mean presenting lumbar Cobb angle measurement (L1-S1) was 36.3 +/- 4.5 degrees (range, 12-77 degrees). Forty patients (50%) had sagittal imbalance. Mean postoperative Cobb angle (L1-S1) was 55.1 +/- 6.6. Thirty-three of 36 patients with segmental kyphosis (92%) had restoration of lordosis. Improvement in alignment was most prominent at the surgical level (mean increase in lordosis, 20.2 +/- 4.2 degrees). The improvement in lumbar lordosis among patients undergoing multilevel TLIFs (27.3 +/- 3.4 degrees) was significantly higher compared with patients undergoing single-level operations (17.4 +/- 4.4) (Student’s t test, P = 0.0004). Thirty of the 40 patients with sagittal imbalance (75%) achieved immediate restoration of normal sagittal balance. The ability to restore normal sagittal balance was correlated with a sagittal imbalance of less than 10 cm (P = 0.0001). Spondylolisthesis was completely corrected at the TLIF site in 90 of 99 levels (91%). Three patients (4%) required reoperation, 2 for implant disengagement and 1 for worsening kyphoscoliosis above the original surgical levels. Two of the 80 patients had pseudoarthrosis; hence, the rate of pseudoarthrosis was 2.5%. CONCLUSION: The TLIF operation is highly effective in improving spinal alignment in patients with degenerative spinal disorders when the appropriate surgical technique is implemented

Keywords : Adult,Aged,Aged,80 and over,diagnostic imaging,Female,Humans,Kyphosis,Longitudinal Studies,Lordosis,Lumbar Vertebrae,Magnetic Resonance Imaging,Male,methods,Middle Aged,physiology,Recovery of Function,Reoperation,Retrospective Studies,Scoliosis,Spinal Fusion,Spine,Spondylolisthesis,surgery,Time Factors,Tomography,X-Ray Computed,Treatment Outcome,, Restoration,Lumbar,Alignment,After, trigger point injections for shoulder pain

Date of Publication : 2009 May

Authors : Jagannathan J;Sansur CA;Oskouian RJ;Fu KM;Shaffrey CI;

Organisation : Department of Neurological Surgery, University of Virginia Health Sciences Center, University of Virginia, Charlottesville, Virginia 22902, USA

Journal of Publication : Neurosurgery

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/19404155

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Radiographic restoration of lumbar alignment after transforaminal lumbar interbody fusion | Piriformis syndrome groin pain

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810