Journal Article

Changes in lumbar lordosis and predicted minimum 5-year surgical outcomes after short-segment transforaminal lumbar interbody fusion

Koichi Nakagawa, Go Kubota, Yawara Eguchi, Masato Sonobe, Yasuhiro Shiga, Hiroshi Takahashi, Takayuki Nakajima, Satoshi Yoh, Yusuke Sato, Fumiaki Terajima, Shuhei Ohyama, Arata Nakajima, Sumihisa Orita, Junya Saito, Yasuchika Aoki, Masahiro Inoue, Kazuhide Inage, Masashi Sato, Masaki Norimoto, Seiji Ohtori

2022

Overview

Although most patients who undergo transforaminal lumbar interbody fusion (TLIF) show favorable surgical results, some still have unfavorable results for various reasons. This study aimed to investigate the influence of differences in lumbar lordosis (LL) between the standing and supine positions (DiLL: supine LL–standing LL) on minimum 5-year surgical outcomes after short-segment TLIF. Ninety-one patients with lumbar degenerative disease who underwent short-segment TLIF (1–2 levels) were categorized based on preoperative differences in LL as DiLL (+) and DiLL (−). Comparison and correlation analyses were performed. The incidence of adjacent segment disease (ASD) by radiology (R-ASD) and symptomatic ASD (S-ASD), bony fusion rates, and pre- and postoperative clinical scores (visual analog scale [VAS]; Japanese Orthopaedic Association [JOA] score; Oswestry disability index (ODI); and Nakai’s score) were evaluated. Postoperatively, VAS for low back pain (LBP) in the sitting position, JOA scores for LBP, lower leg pain, intermittent claudication, ODI, and Nakai’s score were significantly worse in the DiLL (+) group than in the DiLL (−) group. DiLL values were significantly correlated with VAS for LBP, ODI, and Nakai’s score, postoperatively. Positive DiLL values were associated with poorer postoperative outcomes. DiLL is a simple and useful method for predicting mid-term outcomes after TLIF.

• Publisher: Springer Science and Business Media LLC,Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 692/308 / 692/308/409 / Back pain / Cardiovascular diseases / Correlation analysis / Humanities and Social Sciences / Humans / Lordosis / Lordosis - diagnostic imaging / Lordosis - surgery / Low back pain / Lumbar Vertebrae / Lumbar Vertebrae - diagnostic imaging / Lumbar Vertebrae - surgery / Medicine / multidisciplinary / Patients / Q / R / Radiology / Retrospective Studies / Science / Science (multidisciplinary) / Sitting Position / Spinal Fusion / Spinal Fusion - adverse effects / Spinal Fusion - methods / Spinal Fusion - standards / Standing Position / Supine Position / Surgical outcomes / Treatment Outcome