P17. The Effect of Intraoperative Position in Short-segment Posterior Lumbar Interbody Fusion on Maintenance of Lumbar Lordosis

2007 ◽  
Vol 7 (5) ◽  
pp. 90S-91S
Author(s):  
Jae Hyup Lee ◽  
Ji-Ho Lee ◽  
Kang-Sup Yoon ◽  
Seung-Baik Kang ◽  
Chris Jo
Keyword(s):  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Short Segment

Comparative study of multilevel posterior interbody fusion plus anterior longitudinal ligament release versus classic multilevel posterior interbody fusion in the treatment of adult spinal deformities

2019 ◽  
Vol 31 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Silviu Sabou ◽  
Apostolos Lagaras ◽  
Rajat Verma ◽  
Irfan Siddique ◽  
Saeed Mohammad
Keyword(s):  
Spinal Surgery ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Minimal Risk ◽  
Lumbar Interbody Fusion ◽  
Anterior Longitudinal Ligament ◽  
Degenerative Scoliosis ◽  
Release Group ◽  
The Mean

OBJECTIVESagittal imbalance and loss of lumbar lordosis are the main drivers of functional disability in adult degenerative scoliosis. The main limitations of the classic posterior lumbar interbody fusion technique are increased risk of neurological injury and suboptimal correction of the segmental lordosis. Here, the authors describe the radiological results of a modified posterior lumbar interbody fusion and compare the results with a historical cohort of patients.METHODSEighty-two consecutive patients underwent surgical treatment for degenerative scoliosis/kyphosis in a single tertiary referral center for complex spinal surgery. Fifty-five patients were treated using the classic multilevel posterior lumbar interbody fusion (MPLIF) technique and 27 were treated using the modified MPLIF technique to include a release of the anterior longitudinal ligament (ALL) and the annulus. A radiographic review of both series of patients was performed by two independent observers. Functional outcomes were obtained, and patients were registered in the European Spine Tango registry.RESULTSThe mean L4–5 disc angle increased by 3.14° in the classic MPLIF group and by 12.83° in MPLIF plus ALL and annulus release group. The mean lumbar lordosis increased by 15.23° in the first group and by 25.17° in the second group. The L4–S1 lordosis increased on average by 4.92° in the classic MPLIF group and increased by a mean of 23.7° in the MPLIF plus ALL release group when both L4–5 and L5–S1 segments were addressed. There were significant improvements in the Core Outcome Measures Index and EQ-5D score in both groups (p < 0.001). There were no vascular or neurological injuries observed in either group.CONCLUSIONSThe authors’ preliminary results suggest that more correction can be achieved at the disc level using posterior-based ALL and annulus release in conjunction with posterior lumbar interbody fusion. They demonstrate that ALL and annulus release can be performed safely using a posterior-only approach with minimal risk of vascular injury. However, the authors recommend that this approach should only be used by surgeons with considerable experience in anterior and posterior spinal surgery.

Posterior lumbar interbody fusion and segmental lumbar lordosis

2006 ◽  
Vol 17 (2) ◽  
pp. 125-129 ◽  
Author(s):  
Rahul Kakkar ◽  
P. B. R. Sirigiri ◽  
A. Howieson ◽  
A. Siva Raman ◽  
R. J. Crawford
Keyword(s):  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion

scholarly journals Effects of Lordotic Angle of a Cage on Sagittal Alignment and Clinical Outcome in One Level Posterior Lumbar Interbody Fusion with Pedicle Screw Fixation

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ji-Ho Lee ◽  
Dong-Oh Lee ◽  
Jae Hyup Lee ◽  
Hee Jong Shim
Keyword(s):  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Sagittal Alignment ◽  
Screw Fixation ◽  
Posterior Lumbar Interbody Fusion ◽  
Clinical Results ◽  
Pedicle Screw Fixation ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Segmental Lordosis

This study aims to assess the differences in the radiological and clinical results depending on the lordotic angles of the cage in posterior lumbar interbody fusion (PLIF). We reviewed 185 segments which underwent PLIF using two different lordotic angles of 4° and 8° of a polyetheretherketone (PEEK) cage. The segmental lordosis and total lumbar lordosis of the 4° and 8° cage groups were compared preoperatively, as well as on the first postoperative day, 6th and 12th months postoperatively. Clinical assessment was performed using the ODI and the VAS of low back pain. The pre- and immediate postoperative segmental lordosis angles were 12.9° and 12.6° in the 4° group and 12° and 12.0° in the 8° group. Both groups exhibited no significant different segmental lordosis angle and total lumbar lordosis over period and time. However, the total lumbar lordosis significantly increased from six months postoperatively compared with the immediate postoperative day in the 8° group. The ODI and the VAS in both groups had no differences. Cages with different lordotic angles of 4° and 8° showed insignificant results clinically and radiologically in short-level PLIF surgery. Clinical improvements and sagittal alignment recovery were significantly observed in both groups.

Effect of intraoperative position used in posterior lumbar interbody fusion on the maintenance of lumbar lordosis

2008 ◽  
Vol 8 (3) ◽  
pp. 263-270 ◽  
Author(s):  
Jae Hyup Lee ◽  
Ji-Ho Lee ◽  
Kang-Sup Yoon ◽  
Seung-Baik Kang ◽  
Chris H. Jo
Keyword(s):  
Lumbar Spine ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Lumbar Interbody Fusion ◽  
Group I ◽  
Group Ii ◽  
Polyetheretherketone Cage ◽  
Segmental Lordosis

Object The objective in this study was to compare retrospectively the use of different operating tables with different positions for posterior lumbar interbody fusion (PLIF) and the effect on intraoperative and postoperative lumbar lordosis and segmental lordosis. Methods One hundred seventy-two patients with degenerative disease of the lumbar spine who underwent posterior decompression and PLIF in which a 0° polyetheretherketone cage and pedicle screw fixation were used were evaluated. Ninety-one patients underwent surgery on a Wilson table (Group I) and 81 patients were treated on an OSI Jackson spinal table (Group II). Preoperative standing, intraoperative prone, and postoperative standing lateral radiographs were obtained in each patient. The total lumbar and segmental lordosis were compared and analyzed according to the position in which the patients were placed for their operation. Results The intraoperative total lumbar lordosis was significantly decreased compared with the preoperative value. The postoperative total lumbar lordosis was similar, however, to the preoperative values in both groups. In Group I, the intraoperative segmental lordosis of L2–3 and L3–4 was significantly decreased compared with the pre-operative segmental lordosis. In Group II, the intraoperative segmental lordosis of L3–4, L4–5, L5–S1, and L4–S1 was significantly decreased compared with the preoperative segmental lordosis. The postoperative segmental lordosis of L4–5 was significantly decreased and L2–3 was significantly increased compared with the preoperative lordosis in both groups. Conclusions Intraoperative position does not affect postoperative total lumbar lordosis and segmental lordosis in short-segment PLIF of the lumbar spine in a retrospective analysis of the surgical procedure to maintain lordosis.

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