Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis

Bourghli, Anouar; Aunoble, S.; Reebye, O.; Huec, J C Le

doi:10.1007/s00586-011-1934-z

Cited by 76 publications

(57 citation statements)

References 16 publications

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“…There is no attempt to relate lordosis gain to improved patient-related outcomes, yet this relationship is established in the literature [5,7,10,19]. Long-term follow-up would be required to confirm reduced adjacent segment degeneration with improved monosegmental lordosis.…”

Section: Discussionmentioning

confidence: 99%

“…The importance of normal sagittal alignment has been increasingly recognised in multi-segmental fusions for spinal deformity [1][2][3]. With increasing focus on patient-related outcomes, there is mounting evidence that optimum sagittal alignment in lumbar fusion is associated with improved outcomes across differing pathologies [1,[4][5][6][7][8][9], reduced post-surgical pain [1-3, 5-8, 10-13], reduced adjacent segment degeneration [4,5,7,[9][10][11][12][13][14], and reduced revision rates [1-5, 7, 9-11, 13, 15-18].…”

Section: Introductionmentioning

confidence: 99%

“…Pathological processes that result in disc space narrowing will reduce lordosis. Failure to correct this pre-operative sagittal plane deformity will compromise results in both the short and long terms [5,7,10,11,13].…”

Section: Introductionmentioning

confidence: 99%

“…It is interesting, however, that with interbody reconstruction, the degree of lordosis recreation can be limited and may not recreate normality [1][2][3][16][17][18]]-a concern when we recognise the significant lordosis in the normal L4/5 and L5/S1 discs [1,5,7,12].…”

Section: Introductionmentioning

confidence: 99%

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Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

2017

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Purpose To examine monosegmental lordosis after posterior lumbar interbody fusion (PLIF) surgery and relate lordosis to cage size, shape, and placement. Methods Eighty-three consecutive patients underwent single-level PLIF with paired identical lordotic cages involving a wide decompression and bilateral facetectomies. Cage parameters relating to size (height, lordosis, and length) and placement (expressed as a ratio relative to the length of the inferior vertebral endplate) were recorded. Centre point ratio (CPR) was the distance to the centre of both cages and indicated mean position of both cages. Posterior gap ratio (PGR) was the distance to the most posterior cage and indicated position and cage length indirectly. Relationships between lordosis and cage parameters were explored. Results Mean lordosis increased by 5.98°(SD 6.86°). The cages used varied in length from 20 to 27 mm, in lordosis from 10°to 18°, and in anterior cage height from 10 to 17 mm. The mean cage placement as determined by CPR was 0.54 and by PGR was 0.16. The significant correlations were: both CPR and PGR with lordosis gain at surgery (r = 0.597 and 0.537, respectively, p \ 0.001 both), cage lordosis with the final lordosis (r = 0.234, p \ 0.05), and anterior cage height was negatively correlated with a change in lordosis (r = -0.297, p \ 0.01).Conclusion Cage size, shape, and position, in addition to surgical technique, determine lordosis during PLIF surgery. Anterior placement with sufficient ''clear space'' behind the cages is recommended. In addition, cages should be of moderate height and length, so that they act as an effective pivot for lordosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

2017

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“…Sagittal alignment of the spine and pelvis has been increasingly recognized as being an essential aspect to consider in the evaluation and treatment of spinal pathologies [1][2][3]. Recently, several studies revealed that the classic apical hypokyphosis, as have been invariably demonstrated in adolescent idiopathic thoracic scoliosis (AIS), was absent in most cases with Chiari malformationassociated scoliosis (CMS) [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Sagittal spinopelvic alignment in adolescent thoracic scoliosis secondary to Chiari I malformation: a comparison between the left and the right curves

et al. 2013

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Purpose To investigate whether the sagittal morphology differs between the left and right thoracic curves in patients with Chiari malformation-associated scoliosis (CMS). Methods Thirty-four patients with a left thoracic curve constituted the CM-L group, whereas 44 patients with a right thoracic curve were assigned into the CM-R group. Another cohort of 90 age-and gender-matched asymptomatic adolescents was enrolled to serve as the control group. Seven sagittal parameters were evaluated on standing lateral radiographs, including thoracic kyphosis (TK), lumbar lordosis (LL), thoracolumbar junctional kyphosis (TJK), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). Results Compared to the normal controls, the TK, LL and SS were significantly greater in the CM-L group, along with a significantly decreased PT. Similar changes in SS and PT were also demonstrated in the CM-R group, while the TK and LL were found to be relatively normal compared with the control group. Concerning CMS patients with different curve directions, significantly increased TK and LL were observed in the CM-L group, whereas all three pelvic parameters were similar for the two groups. In addition, no significant differences were noted between the three groups in PI, TJK or SVA. Moreover, the LL was strongly related to the TK and SS in all three groups, but to the PI only in the control and CM-R groups. A significant correlation was also noted between TK and SS in the CM-L group. Conclusions Significant differences in sagittal profiles indeed exist between CMS patients and healthy adolescents, as well as between CMS patients with different curve directions. In CMI patients with a left thoracic curve, compensatory alterations appear to occur in LL in response to the increased TK to maintain a balanced posture.

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Surgical Treatment of Lumbar Spondylolisthesis Due to Isthmic Lysis

Rigal

Plais

Faúndez

et al. 2016

Surgery of the Spine and Spinal Cord

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Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis

Abstract: Surgical management of low- and mid-grade isthmic spondylolisthesis showed good clinical outcome with restoration of correct values for the pelvic position-dependent parameters, i.e., pelvis tilt, sacral slope, C7 plumb line position and SSA.

Cited by 76 publications

References 16 publications

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

Sagittal spinopelvic alignment in adolescent thoracic scoliosis secondary to Chiari I malformation: a comparison between the left and the right curves

Surgical Treatment of Lumbar Spondylolisthesis Due to Isthmic Lysis

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