Journal article
Do On-Table Radiographs Predict Postoperative Sagittal Alignment after Posterior Lumbar Fusion?
WORLD NEUROSURGERY, v 174, pE118
Jun 2023
PMID: 36889640
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE: To determine if intraoperative on-table lumbar lordosis and segmental lordosis correlate with postoperative lordosis following single-level posterolat-eral decompression and fusion (PLDF) or transforaminal lumbar interbody fusion (TLIF).METHODS: Electronic medical records were reviewed for patients & DDAG;18 years old who underwent PLDF or TLIF between 2012 and 2020. Lumbar lordosis and segmental lordosis were compared between pre-, intra-, and post-operative radiographs using paired t tests. Significance was set at P < 0.05.RESULTS: A total of 200 patients met inclusion criteria. No significant differences in preoperative, intraoperative, or postoperative measurements were found between groups. Patients who underwent PLDF experienced less disc height loss over 1 year postoperatively (PLDF: 0.45 + 0.9 mm vs. TLIF: 1.2 + 1.4 mm, P < 0.001). Lumbar lordosis significantly decreased between intraoperative to post-operative radiographs at 2-6 weeks for PLDF (A:-4.0 & DEG;, P< 0.001) and TLIF (A:-5.6 & DEG;, P< 0.001), but no change was identified between the intraoperative and >6 month post-operative radiographs for PLDF (A:-0.3 & DEG;, P = 0.634) or TLIF (A:-1.6 & DEG;, P = 0.087). Segmental lordosis significantly increased from the preoperative to post-instrumentation intraoperative radiographs for PLDF (A: 2.7 & DEG;, P < 0.001) and TLIF (A: 1.8 & DEG;, P < 0.001), but it subsequently decreased at the final follow up for PLDF (A:-1.9 & DEG;, P< 0.001) and TLIF (A:-2.3 & DEG;, P < 0.001).CONCLUSIONS: Subtle decreases in lumbar lordosis may be noticed in early postoperative radiographs compared with intraoperative images on Jackson operative tables. However, these changes are not present at 1-year follow-up as lumbar lordosis increases to a similar level as intraoperative fixation.
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Details
- Title
- Do On-Table Radiographs Predict Postoperative Sagittal Alignment after Posterior Lumbar Fusion?
- Publication Details
- WORLD NEUROSURGERY, v 174, pE118
- Publisher
- ELSEVIER SCIENCE INC; NEW YORK
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:001015350800001
- Scopus ID
- 2-s2.0-85152673894
- Other Identifier
- 991021861197304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery