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Sagittal imbalance syndrome, a new concept, helps determining a long fusion for patients with degenerative lumbar spinal stenosis and severe global sagittal imbalance – Lumbar Spinal Stenosis

This article retrospectively examines the clinical and radiographic outcomes of elderly patients with degenerative lumbar spinal stenosis (DLSS) and severe global sagittal imbalance who underwent different fusion levels. The study included 214 patients with DLSS and severe sagittal imbalance, with 54 of them experiencing sagittal imbalance syndrome. The results showed that patients with sagittal imbalance syndrome had more paraspinal muscle degeneration and less compensatory potential for sagittal imbalance. The study found that lumbar decompression with a short fusion had inferior surgical outcomes in terms of living quality and proximal junctional complications for DLSS patients with sagittal imbalance syndrome

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSION: Our results indicated that DLSS patients with sagittal imbalance syndrome had inferior surgical outcomes in terms of living quality and proximal junctional complication after lumbar decompression with a short fusion.

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J Orthop Surg Res. 2024 Feb 13;19(1):138. doi: 10.1186/s13018-024-04613-2.ABSTRACTOBJECTIVE: To retrospectively investigate the postoperative clinical and radiographic outcomes in elderly patients with degenerative lumbar spinal stenosis (DLSS) and severe global sagittal imbalance who underwent different fusion levels.METHODS: A total of 214 patients with DLSS and severe global sagittal imbalance were included. Sagittal imbalance syndrome was,

J Orthop Surg Res. 2024 Feb 13;19(1):138. doi: 10.1186/s13018-024-04613-2.

ABSTRACT

OBJECTIVE: To retrospectively investigate the postoperative clinical and radiographic outcomes in elderly patients with degenerative lumbar spinal stenosis (DLSS) and severe global sagittal imbalance who underwent different fusion levels.

METHODS: A total of 214 patients with DLSS and severe global sagittal imbalance were included. Sagittal imbalance syndrome was defined as the severe decompensated radiographic global sagittal imbalance accompanied with the following symptoms: severe back pain in naturel posture that disappears or significantly relieves in support position, living disability with ODI score > 40% and dynamic sagittal imbalance. Thereinto, 54 patients were found with sagittal imbalance syndrome and were performed the lumbar decompression with a long thoracolumbar fusion (Group A) or a short lumbar fusion (Group B). Thirty patients without sagittal imbalance syndrome who underwent short lumbar decompression and fusion were selected as the control (Group C).

RESULTS: Patients with sagittal imbalance syndrome were detected to have more paraspinal muscle degeneration and less compensatory potentials for sagittal imbalance (smaller thoracic kyphosis and larger pelvic tilt) than those without this diagnosis. Postoperative comparisons revealed significant restoration of global sagittal alignment and balance and improvement of living quality in Groups A and C at the final follow-up. Six patients in Group B and one in Group A were found to have proximal junctional complication during follow-up.

CONCLUSION: Our results indicated that DLSS patients with sagittal imbalance syndrome had inferior surgical outcomes in terms of living quality and proximal junctional complication after lumbar decompression with a short fusion.

PMID:38351135 | DOI:10.1186/s13018-024-04613-2

The London Spine Unit : most experienced spine hospital in London

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Sagittal imbalance syndrome, a new concept, helps determining a long fusion for patients with degenerative lumbar spinal stenosis and severe global sagittal imbalance

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J Orthop Surg Res. 2024 Feb 13;19(1):138. doi: 10.1186/s13018-024-04613-2.ABSTRACTOBJECTIVE: To retrospectively investigate the postoperative clinical and radiographic outcomes in elderly patients with degenerative lumbar spinal stenosis (DLSS) and severe global sagittal imbalance who underwent different fusion levels.METHODS: A total of 214 patients with DLSS and severe global sagittal imbalance were included. Sagittal imbalance syndrome was
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