Influence of Preoperative Difference in Lumbar Lordosis Between the Standing and Supine Positions on Clinical Outcomes After Single-level Transforaminal Lumbar Interbody Fusion: Minimum 2-year Follow-up.
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
15 Aug 2021
15 Aug 2021
Historique:
pubmed:
26
1
2021
medline:
19
8
2021
entrez:
25
1
2021
Statut:
ppublish
Résumé
Retrospective cohort study. The aim of this study was to investigate whether a preoperative difference in lumbar lordosis (D-LL) between the standing and supine positions is associated with clinical outcomes after transforaminal lumbar interbody fusion (TLIF). Several factors have been reported to be associated with surgical outcomes after TLIF. However, the association between preoperative D-LL and clinical outcomes after TLIF is unknown. We enrolled 45 lumbar degenerative disease patients (mean age: 65.7 ± 11.3 years old; 24 males) treated with single-level TLIF. Surgical outcomes were assessed using Oswestry disability index, visual analog scale (VAS; low back pain [LBP], lower-extremity pain, numbness, LBP in motion, in standing, and in sitting), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, Japanese Orthopaedic Association score for intermittent claudication (JOA score), and Nakai's scoring system. The preoperative D-LL between the standing radiograph and computed tomography (CT) in the supine position was defined as LL in supine CT-standing radiograph. Patients were divided into two groups according to D-LL value (D-LL >-4°, and D-LL ≤-4°). Clinical outcomes were compared between the groups, and correlations between preoperative D-LL and clinical outcomes were analyzed. There were no significant differences in preoperative clinical parameters between the two groups. Postoperative VASs for lower extremity pain, numbness, LBP in standing, and JOA score in D-LL >-4° group were significantly worse than in the D-LL ≤-4° group (P < 0.05). Preoperative D-LL showed a weak correlation with postoperative lower extremity pain and numbness (P < 0.05). This study revealed that lumbar degenerative disease patients, who have greater preoperative kyphotic lumbar alignment in the standing versus supine position, tend to have postoperative residual symptoms after TLIF. A preoperative comparison of lateral radiographs between the standing and supine positions is useful to predict patients' postoperative residual symptoms.Level of Evidence: 3.
Sections du résumé
STUDY DESIGN
METHODS
Retrospective cohort study.
OBJECTIVE
OBJECTIVE
The aim of this study was to investigate whether a preoperative difference in lumbar lordosis (D-LL) between the standing and supine positions is associated with clinical outcomes after transforaminal lumbar interbody fusion (TLIF).
SUMMARY OF BACKGROUND DATA
BACKGROUND
Several factors have been reported to be associated with surgical outcomes after TLIF. However, the association between preoperative D-LL and clinical outcomes after TLIF is unknown.
METHODS
METHODS
We enrolled 45 lumbar degenerative disease patients (mean age: 65.7 ± 11.3 years old; 24 males) treated with single-level TLIF. Surgical outcomes were assessed using Oswestry disability index, visual analog scale (VAS; low back pain [LBP], lower-extremity pain, numbness, LBP in motion, in standing, and in sitting), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, Japanese Orthopaedic Association score for intermittent claudication (JOA score), and Nakai's scoring system. The preoperative D-LL between the standing radiograph and computed tomography (CT) in the supine position was defined as LL in supine CT-standing radiograph. Patients were divided into two groups according to D-LL value (D-LL >-4°, and D-LL ≤-4°). Clinical outcomes were compared between the groups, and correlations between preoperative D-LL and clinical outcomes were analyzed.
RESULTS
RESULTS
There were no significant differences in preoperative clinical parameters between the two groups. Postoperative VASs for lower extremity pain, numbness, LBP in standing, and JOA score in D-LL >-4° group were significantly worse than in the D-LL ≤-4° group (P < 0.05). Preoperative D-LL showed a weak correlation with postoperative lower extremity pain and numbness (P < 0.05).
CONCLUSION
CONCLUSIONS
This study revealed that lumbar degenerative disease patients, who have greater preoperative kyphotic lumbar alignment in the standing versus supine position, tend to have postoperative residual symptoms after TLIF. A preoperative comparison of lateral radiographs between the standing and supine positions is useful to predict patients' postoperative residual symptoms.Level of Evidence: 3.
Identifiants
pubmed: 33492084
doi: 10.1097/BRS.0000000000003955
pii: 00007632-202108150-00007
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1070-1080Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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