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What Affects Segmental Lordosis of the Surgical Site after Minimally Invasive Transforaminal Lumbar Interbody Fusion?

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Purpose: This study was undertaken to identify factors that affect segmental lordosis (SL) after minimally invasive transforaminallumbar interbody fusion (MIS-TLIF) by comparing patients whose postoperative SL increased with those whose decreased. Materials and Methods: Fifty-five patients underwent MIS-TLIF at our institute from January 2018 to September 2019. Demo graphic, pre- and postoperative radiologic, and cage-related factors were included. Statistical analyses were designed to comparepatients whose SL increased with decreased after surgery. Results: After surgery, SL increased in 34 patients (group I) and decreased in 21 patients (group D). The index level, disc lordosis,SL, lumbar lordosis, proximal lordosis (PL), and Y-axis position of the cage (Yc) differed significantly between groups I and D. Thecage in group I was more anterior than that in group D (Yc: 55.84% vs. 51.24%). Multivariate analysis showed that SL decreasedmore significantly after MIS-TLIF when the index level was L3/4 rather than L4/5 [odds ratio (OR): 0.46, p=0.019], as preoperativeSL (OR: 0.82, p=0.037) or PL (OR: 0.68, p=0.028) increased, and as the cage became more posterior (OR: 1.10, p=0.032). Conclusion: Changes in SL after MIS-TLIF appear to be associated with preoperative SL and PL, index level, and Yc. An index levelat L4/5 instead of L3/4, smaller preoperative SL or PL, and an anterior position of the cage are likely to result in increased SL afterMIS-TLIF.

Abstract

Purpose: This study was undertaken to identify factors that affect segmental lordosis (SL) after minimally invasive transforaminallumbar interbody fusion (MIS-TLIF) by comparing patients whose postoperative SL increased with those whose decreased. Materials and Methods: Fifty-five patients underwent MIS-TLIF at our institute from January 2018 to September 2019. Demo graphic, pre- and postoperative radiologic, and cage-related factors were included. Statistical analyses were designed to comparepatients whose SL increased with decreased after surgery. Results: After surgery, SL increased in 34 patients (group I) and decreased in 21 patients (group D). The index level, disc lordosis,SL, lumbar lordosis, proximal lordosis (PL), and Y-axis position of the cage (Yc) differed significantly between groups I and D. Thecage in group I was more anterior than that in group D (Yc: 55.84% vs. 51.24%). Multivariate analysis showed that SL decreasedmore significantly after MIS-TLIF when the index level was L3/4 rather than L4/5 [odds ratio (OR): 0.46, p=0.019], as preoperativeSL (OR: 0.82, p=0.037) or PL (OR: 0.68, p=0.028) increased, and as the cage became more posterior (OR: 1.10, p=0.032). Conclusion: Changes in SL after MIS-TLIF appear to be associated with preoperative SL and PL, index level, and Yc. An index levelat L4/5 instead of L3/4, smaller preoperative SL or PL, and an anterior position of the cage are likely to result in increased SL afterMIS-TLIF.

참고문헌 (40)

  1. Kepler CK, "Restoration of lordosis and disk height after single-level transforaminal lumbar interbody fusion", Orthop Surg, 4, pp.15~20 (2012)
  2. Tian H, "Adequate restoration of disc height and segmental lordosis by lumbar interbody fusion decreases adjacent segment degeneration", World Neurosurg, 118, pp.e856~e864 (2018)
  3. Brodano GB, "Transforaminal lumbar interbody fusion in degenerative disk disease and spondylolisthesis grade I : minimally invasive versus open surgery", J Spinal Disord Tech, 28, pp.E559~E564 (2015)
  4. Choi WS, "Minimally invasive transforaminal lumbar interbody fusion at L5-S1 through a unilateral approach : technical feasibility and outcomes", Biomed Res Int, 2016, pp.2518394~ (2016)
  5. Lee WC, "Minimally invasive transforaminal lumbar interbody fusion in multilevel : comparison with conventional transforaminal interbody fusion", World Neurosurg, 85, pp.236~243 (2016)
  6. 이창규, "Minimally Invasive Transforaminal Lumbar Interbody Fusion Using a Single Interbody Cage and a Tubular Retraction System : Technical Tips, and Perioperative, Radiologic and Clinical Outcomes", 대한신경외과학회지, 48(3), pp.219~224 (2010), 대한신경외과학회
  7. Peng CW, "Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion", Spine(Phila Pa 1976), 34, pp.1385~1389 (2009)
  8. Rodríguez-Vela J, "Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3-to 4-year follow-up", Eur Spine J, 22, pp.2857~2863 (2013)
  9. Than KD, "Clinical and radiographic parameters associated with best versus worst clinical outcomes in minimally invasive spinal deformity surgery", J Neurosurg Spine, 25, pp.21~25 (2016)
  10. Zaïri F, "Transforaminal lumbar interbody fusion: goals of the minimal invasive approach", Neurochirurgie, 59, pp.171~177 (2013)
  11. 박융, "Minimally Invasive Lumbar Spinal Fusion Is More Effective Than Open Fusion: A Meta-Analysis", Yonsei Medical Journal, 59(4), pp.524~538 (2018), 연세대학교의과대학[DOI]
  12. Alvi MA, "Assessing the difference in clinical and radiologic outcomes between expandable cage and nonexpandable cage among patients undergoing minimally invasive transforaminal interbody fusion : a systematic review and meta-analysis", World Neurosurg, 127, pp.596~606.e1 (2019)
  13. Chang CC, "Long-term radiographic outcomes of expandable versus static cages in transforaminal lumbar interbody fusion", J Neurosurg Spine, 34, pp.471~480 (2021)
  14. Choi WS, "Minimally invasive transforaminal lumbar interbody fusion using banana-shaped and straight cages : radiological and clinical results from a prospective randomized clinical trial", Neurosurgery, 82, pp.289~298 (2018)
  15. Hawasli AH, "Minimally invasive transforaminal lumbar interbody fusion with expandable versus static interbody devices : radiographic assessment of sagittal segmental and pelvic parameters", Neurosurg Focus, 43, pp.E10~ (2017)
  16. Khechen B, "Static versus expandable devices provide similar clinical outcomes following minimally invasive transforaminal lumbar interbody fusion", HSS J, 16, pp.46~53 (2020)
  17. Kim C, "Twoyear clinical and radiographic outcomes of expandable interbody spacers following minimally invasive transforaminal lumbar interbody fusion : a prospective study", Int J Spine Surg, 14, pp.518~526 (2020)
  18. Lindley TE, "Effect of steerable cage placement during minimally invasive transforaminal lumbar interbody fusion on lumbar lordosis", J Clin Neurosci, 21, pp.441~444 (2014)
  19. Lovecchio FC, "Does interbody cage lordosis impact actual segmental lordosis achieved in minimally invasive lumbar spine fusion", Neurosurg Focus, 49, pp.E17~ (2020)
  20. Massie LW, "Assessment of radiographic and clinical outcomes of an articulating expandable interbody cage in minimally invasive transforaminal lumbar interbody fusion for spondylolisthesis", Neurosurg Focus, 44, pp.E8~ (2018)
  21. McMordie JH, "Clinical and shortterm radiographic outcomes of minimally invasive transforaminal lumbar interbody fusion with expandable lordotic devices", Neurosurgery, 86, pp.E147~E155 (2020)
  22. Tan LA, "Clinical and radiographic outcomes after minimally invasive transforaminal lumbar interbody fusion-early experience using a biplanar expandable cage for lumbar spondylolisthesis", Int J Spine Surg, 14, pp.S39~S44 (2020)
  23. Le Huec JC, "Sagittal balance of the spine", Eur Spine J, 28, pp.1889~1905 (2019)
  24. 김광렬, "The Technical Feasibility of Unilateral Biportal Endoscopic Decompression for The Unpredicted Complication Following Minimally Invasive Transforaminal Lumbar Interbody Fusion: Case Report", Neurospine, 17, pp.154~159 (2020), 대한척추신경외과학회[DOI]
  25. Park B, "Reduction and monosegmental fusion for lumbar spondylolisthesis with a long tab percutaneous pedicle screw system : "swing"technique", Neurosurg Focus, 46, pp.E11~ (2019)
  26. Kim JY, "Minimally invasive transforaminal lumbar interbody fusion for spondylo listhesis : comparison between isthmic and degenerative spondylolisthesis", World Neurosurg, 84, pp.1284~1293 (2015)
  27. Kang MS, "Minimally invasive transforaminal lumbar interbody fusion with unilateral pedicle screw fixation : comparison between primary and revision surgery", Biomed Res Int, 2014, pp.919248~ (2014)
  28. Choi UY, "Unilateral versus bilateral percutaneous pedicle screw fixation in minimally invasive transforaminal lumbar interbody fusion", Neurosurg Focus, 35, pp.E11~ (2013)
  29. Pierre-Olivier Champagne, "Sagittal Balance Correction Following Lumbar Interbody Fusion: A Comparison of the Three Approaches", Asian Spine Journal, 13(3), pp.450~458 (2019), 대한척추외과학회[DOI]
  30. Berlin C, "Preoperative lordosis in L4", 5 predicts segmental lordosis correction achievable by transforaminal lumbar interbody fusion, 2021, pp.30, 1277~1284
  31. Carlson BB, "Restoration of lumbar lordosis after minimally invasive transforaminal lumbar interbody fusion : a systematic review", Spine J, 19, pp.951~958 (2019)
  32. Renaud Lafage, "Surgical Planning for Adult Spinal Deformity: Anticipated Sagittal Alignment Corrections According to the Surgical Level", Global Spine Journal, 12(8), pp.1761~1769 (2021), SAGE Publications[DOI]
  33. Pesenti S, "The amount of proximal lumbar lordosis is related to pelvic incidence", Clin Orthop Relat Res, 476, pp.1603~1611 (2018)
  34. Ricciardi L, "Intraoperative and postoperative segmental lordosis mismatch : analysis of 3 fusion techniques", World Neurosurg, 115, pp.e659~e663 (2018)
  35. Bernhardt M, "Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction", Spine(Phila Pa 1976), 14, pp.717~721 (1989)
  36. Zhang S, "Double-level lumbar spondylolysis and spondylolisthesis : a retrospective study", J Orthop Surg Res, 13, pp.55~ (2018)
  37. Chan V, "Determination of dynamic instability in lumbar spondylolisthesis using flexion and extension standing radiographs versus neutral standing radiograph and supine MRI", J Neurosurg Spine, 31, pp.229~235 (2019)
  38. He D, "Prevalence of lumbar spondylolisthesis in middle-aged people in beijing community", Orthop Surg, 13, pp.202~206 (2021)
  39. Ramírez León JF, "Standalone lordotic endoscopic wedge lumbar interbody fusion(LEW-LIFTM)with a threaded cylindrical peek cage : report of two cases", J Spine Surg, 6(Suppl 1), pp.S275~S284 (2020)
  40. Hong TH, "Does lordotic angle of cage determine lumbar lordosis in lumbar interbody fusion", Spine (Phila Pa 1976), 42, pp.E775~E780 (2017)

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