The Importance of Spinopelvic Parameters in Recurrent Lumbar Disk Herniation.
Journal
Clinical spine surgery
ISSN: 2380-0194
Titre abrégé: Clin Spine Surg
Pays: United States
ID NLM: 101675083
Informations de publication
Date de publication:
30 Oct 2023
30 Oct 2023
Historique:
received:
21
05
2023
accepted:
03
10
2023
medline:
9
11
2023
pubmed:
9
11
2023
entrez:
9
11
2023
Statut:
aheadofprint
Résumé
Retrospective clinical study. We aimed to investigate preoperative spinopelvic mismatch as a risk factor for recurrent lumbar disk herniation (RLDH) in patients undergoing lumbar disk herniation (LDH) surgery. Spinopelvic parameters have been associated with lumbar degenerative diseases, particularly LDH. However, the relationship between these parameters and RLDH has yet to be studied. Data of 1453 patients aged ≥18 who underwent single-level, unilateral fenestration microdiscectomy for the first time in our hospital between 2013 and 2019 were reviewed. The study group comprised 88 patients who underwent surgery for RLDH. The control group comprised 101 randomly selected patients who underwent surgery for LDH but not RLDH. Age, sex, body mass index, occupational activity level, operative level, Roussouly classification type, and time to recurrence were recorded. Moreover, pelvic incidence, lumbar lordosis (LL), interverteberal disk height (IDH), segmental lordosis, sacral slope (SS), pelvic tilt (PT), and sacral table angle (ST) were measured for each patient. Pelvic mismatch was calculated. Mean age was 46.5±11.4 y (range, 20-70). Both groups were similar concerning age, sex, body mass index, occupational activity level, and level of surgery. The mean time to recurrence was 167.3±36.6 d (range, 62-363). Measurements in the RLDH group were as follows: IDH=7.6±1.5 mm, pelvic incidence =54.4°±10.1°, LL=47.3°±13°, segmental lordosis =9.3°±5°, SS=35.1°±9.9°, and PT=19.3°±7.3°. Mean IDH was significantly lower in the RLDH group (P=0.02). Less LL and lower PT at L3-4 level and increased SS at L5-S1 level were considered risk factors for RLDH. This study showed that preoperative low IDH is at higher risk for RLDH in patients undergoing LDH surgery. LL, PT, and SS may be risk factors for specific levels.
Sections du résumé
STUDY DESIGN
METHODS
Retrospective clinical study.
OBJECTIVES
OBJECTIVE
We aimed to investigate preoperative spinopelvic mismatch as a risk factor for recurrent lumbar disk herniation (RLDH) in patients undergoing lumbar disk herniation (LDH) surgery.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Spinopelvic parameters have been associated with lumbar degenerative diseases, particularly LDH. However, the relationship between these parameters and RLDH has yet to be studied.
MATERIALS AND METHODS
METHODS
Data of 1453 patients aged ≥18 who underwent single-level, unilateral fenestration microdiscectomy for the first time in our hospital between 2013 and 2019 were reviewed. The study group comprised 88 patients who underwent surgery for RLDH. The control group comprised 101 randomly selected patients who underwent surgery for LDH but not RLDH. Age, sex, body mass index, occupational activity level, operative level, Roussouly classification type, and time to recurrence were recorded. Moreover, pelvic incidence, lumbar lordosis (LL), interverteberal disk height (IDH), segmental lordosis, sacral slope (SS), pelvic tilt (PT), and sacral table angle (ST) were measured for each patient. Pelvic mismatch was calculated.
RESULTS
RESULTS
Mean age was 46.5±11.4 y (range, 20-70). Both groups were similar concerning age, sex, body mass index, occupational activity level, and level of surgery. The mean time to recurrence was 167.3±36.6 d (range, 62-363). Measurements in the RLDH group were as follows: IDH=7.6±1.5 mm, pelvic incidence =54.4°±10.1°, LL=47.3°±13°, segmental lordosis =9.3°±5°, SS=35.1°±9.9°, and PT=19.3°±7.3°. Mean IDH was significantly lower in the RLDH group (P=0.02). Less LL and lower PT at L3-4 level and increased SS at L5-S1 level were considered risk factors for RLDH.
CONCLUSION
CONCLUSIONS
This study showed that preoperative low IDH is at higher risk for RLDH in patients undergoing LDH surgery. LL, PT, and SS may be risk factors for specific levels.
Identifiants
pubmed: 37941103
doi: 10.1097/BSD.0000000000001546
pii: 01933606-990000000-00229
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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