Segmental coupling effects during correction of three-dimensional lumbar deformity using lateral lumbar interbody fusion

Abstract

Purpose Lateral lumbar interbody fusion (LLIF) has been performed to correct spinal deformity associated with lumbar degenerative disease. Although its usefulness has been studied, there are no reports of quantitative evaluation in three dimensions. Our purpose is to quantitate 3D deformity of the patients with lumbar degenerative disease and correction of the deformity by LLIF using patient-specific 3D CT models. Methods We measured the disc height and 3D alignment of the lumbar spine in 28 patients with degenerative disease undergoing LLIF using patient-specific 3D CT models created preoperatively and 3 months after surgery. The 3D alignment was calculated as wedge, lordosis and axial rotation angles at each motion segment. The disc height and the rotational angles were compared between before and after LLIF. Results A strong positive correlation was found between the wedge angle and the axial rotation angles (r = 0.718, P < 0.001) in the patients with lumbar degenerative disease preoperatively. The wedge and axial rotation angles decreased after surgery (P < 0.001 and P < 0.001, respectively). A positive correlation was found between the corrected wedge angle and the corrected axial rotation angle (r = 0.46, P < 0.001). Conclusion The present study demonstrated positive correlations between the wedge deformity and the axial rotational deformity in the patients with lumbar degenerative disease. The axial rotational deformity was simultaneously corrected with LLIF only by leveling the intervertebral wedge deformity via cage insertion without additional correction procedure.

The Optimal Patient Position on the Surgical Table for Lateral Lumbar Interbody Fusion in Adult Spinal Deformity Using Three-Dimensional Computed Tomography: A Retrospective Study

“…Previous studies reported the correlation between the coronal Cobb angle and vertebral rotation in adolescent idiopathic scoliosis 10,11) . Additionally, the correlation between wedging deformity and axial rotational deformity in patients with lumbar degenerative scoliosis has been reported previously 12) . However, this is the first report to provide a prediction equation for OMA utilizing the coronal Cobb angle.…”

Radiological Outcomes of Reduction Surgery for Degenerative Lumbar Spondylolisthesis Using Long Arm Pedicle Screws

“…There was no alteration in other spinopelvic parameters, which may be due to the fact that the correction of spinopelvic parameters depends not only on the reduction of listhesis; factors other than vertebral displacement contribute to the resulting spinopelvic parameters. Yamaguchi et al 15 found that there was an increase in lumbar lordosis after vertebral fusion. They revealed that the improvement in one of the spinopelvic parameters was not only caused by changes in postoperative anatomy, but rather the return of spinopelvic parameters to normal values due to complaints of back and leg pain having improved postoperatively.…”

Correcting intervertebral rotation and scoliosis simultaneously by oblique lumbar interbody fusion: a 3D analysis of EOS images

“…We reviewed the previous research focusing on the simultaneous motion effects of adult degenerative vertebrae. Yamaguchi et al utilized patient-specific 3D CT models to measure the disc height and 3D alignments, including the wedge, lordosis, and axial rotation angles, at each motion segment ( 20 ). They found positive correlations between the preoperative wedge and the axial rotation angles, as well as between the corrected wedge and the corrected axial rotation angles, which they referred to as “coupled motion”.…”