Factors associated with improvement in sagittal spinal alignment after microendoscopic laminotomy in patients with lumbar spinal canal stenosis

Dohzono, Sho; Toyoda, Hiromitsu; Takahashi, Shinji; Matsumoto, Tomiya; Suzuki, Akinobu; Terai, Hidetomi; Nakamura, Hiroaki

doi:10.3171/2015.12.spine15805

Cited by 33 publications

(30 citation statements)

References 22 publications

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“…Of 18 studies, three failed to produce the data needed for the meta-synthesis [27][28][29]. Thus, the quantitative meta-analysis was performed on 15 studies [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. LSS had been used as an inclusion criterion in 15 studies.…”

Section: Resultsmentioning

confidence: 99%

“…A single previous systematic review of the topic, which included 10 studies (eight of which were included in our review) [57], while lacking a quantitative meta-analysis, estimated that decompression surgery led to SVA correction in 25% to 73% of patients. It has also been suggested that greater PI-LL preoperatively correlates with residual sagittal malalignment postoperatively, which could be explained by structural degenerative changes rather than by reversible changes due to LSS itself [33,34,40].…”

Section: Discussionmentioning

confidence: 99%

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Effect of lumbar laminectomy on spinal sagittal alignment: a systematic review

et al. 2021

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Purpose Positive spinal sagittal alignment is known to correlate with pain and disability. The association between lumbar spinal stenosis and spinal sagittal alignment is less known, as is the effect of lumbar decompressive surgery on the change in that alignment. The objective was to study the evidence on the effect of lumbar decompressive surgery on sagittal spinopelvic alignment. Methods The Cochrane Controlled Trials Register (CENTRAL), Medline, Embase, Scopus and Web of Science databases were searched in October 2019, unrestricted by date of publication. The study selection was performed by two independent reviewers. The risk of systematic bias was assessed according to the NIH Quality Assessment Tool. The data were extracted using a pre-defined standardized form. Results The search resulted in 807 records. Of these, 18 were considered relevant for the qualitative analysis and 15 for the meta-synthesis. The sample size varied from 21 to 89 and the average age was around 70 years. Decompression was mostly performed on one or two levels and the surgical techniques varied widely. The pooled effect sizes were most statistically significant but small. For lumbar lordosis, the effect size was 3.0 (95% CI 2.2 to 3.7) degrees. Respectively, for pelvic tilt and sagittal vertical axis, the effect sizes were − 1.6 (95% CI .2.6 to − 0.5) degrees and − 9.6 (95% CI − 16.0 to − 3.3) mm. Conclusions It appears that decompression may have a small, statistically significant but probably clinically insignificant effect on lumbar lordosis, sagittal vertical axis and pelvic tilt.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of lumbar laminectomy on spinal sagittal alignment: a systematic review

et al. 2021

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“…Most studies 9–74 used conventional MRI for measuring FI. In the field of MRI sequence, our results showed that T2‐weighted images 10,12–14,17,18,20,24,25,27,29,30,32–35,37,39–53,55,56,58–63,65,66,69,70 were used in quantitative assessments more often. It is expedient for orthopaedists to evaluate FI on frequently‐used T2‐weighted images.…”

Section: Literature Reviewmentioning

confidence: 99%

Imaging Evaluation of Fat Infiltration in Paraspinal Muscles on MRI: A Systematic Review with a Focus on Methodology

Han

Jiang

Zhang

et al. 2021

Orthopaedic Surgery

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Purpose: Numerous studies have applied a variety of methods to assess paraspinal muscle degeneration. However, the methodological differences in imaging evaluation may lead to imprecise or inconsistent results. This article aimed to provide a pragmatic summary review of the current imaging modalities, measurement protocols, and imaging parameters in the evaluation of paraspinal muscle fat infiltration (FI) in MRI studies.Methods: Web of Science, EMBASE, and PubMed were searched from January 2005 to March 2020 to identify studies that examined the FI of paraspinal muscles on MRI among patients with lumbar degenerative diseases.Results: Intramyocellular lipids measured by magnetic resonance spectroscopy and FI measured by chemical-shift MRI were both correlated to low back pain and several degenerative lumbar diseases, whereas results on the relationship between FI and degenerative lumbar pathologies using conventional MRI were conflicting. Multi-segment measurement of FI at the lesion segment and adjacent segments could be a prognostic indicator for lumbar surgery. Most studies adopted the center of the intervertebral disc or endplate as the level of slice to evaluate the FI. Compared with visual semiquantitative assessment, quantitative parameters appeared to be precise for eliminating individual or modality differences. It has been demonstrated that fat CSA/total CSA (based on area) and muscle-fat index (based on signal intensity) as quantitative FI parameters are associated with multiple lumbar diseases and clinical outcomes after surgery. Conclusion:Having a good command of the methodology of paraspinal muscle FI on MRI was effective for diagnosis and prognosis in clinical practice.

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“…1,2 Several studies on improved sagittal alignment after decompression alone in lumbar spinal stenosis (LSS) patients were recently published. [3][4][5] We also reported previously on the relation between preoperative sagittal imbalance and LBP before and after decompression surgery in LSS patients. 6 Degenerative spondylolisthesis (DS), when lumbar vertebrae slip forward onto lower vertebral bodies, is also associated with spinopelvic sagittal imbalance.…”

Section: Introductionmentioning

confidence: 70%