Background and Objectives: Adult spinal deformity (ASD) surgery, L5-S1 lordosis is very important factor. The main objective of the research is to retrospectively compare symptomatic presentation and radiological presentation in the sequelae of oblique lumbar inter-body spinal fusion at L5-S1 (OLIF51) and transforaminal lumbar interbody fusion (TLIF) for ASD. Materials and Methods: We retrospectively evaluated 54 patients who underwent corrective spinal fusion for ASD between October 2019 and January 2021. Thirteen patients underwent OLIF51 (average 74.6 years old, group O) and 41 patients underwent TLIF51 (average 70.5 years old, group T). Mean follow-up period was 23.9 months for group O and 28.9 months for group T, ranging from 12 to 43 months. Clinical and radiographic outcomes are assessed using values including visual analogue scale (VAS) for back pain and Oswestry disability index (ODI). Radiographic evaluation was also collected preoperatively and at 6, 12, and 24 months postoperatively. Results: Surgical time in group O was less than that in group T (356 min vs. 492 min, p = 0.003). However, intraoperative blood loss of both groups were not significantly different (1016 mL vs. 1252 mL, p = 0.274). Changes in VAS and ODI were similar in both groups. L5-S1 angle gain and L5-S1 height gain in group O were significantly better than those of group T (9.4° vs. 1.6°, p = 0.0001, 4.2 mm vs. 0.8 mm, p = 0.0002). Conclusions: Clinical outcomes were not significantly different in both groups, but surgical time in OLIF51 was significantly less than that in TLIF51. The radiographic outcomes showed that OLIF51 created more L5-S1 lordosis and L5-S1 disc height compared with TLIF 51.

Adult spinal deformity (ASD) is highly prevalent in persons older than 65 years, affecting more than 30% of the total population. There are many important reports that describe excellent postoperative results for ASD surgery. However, there is no report that describes a chronological evaluation of gait ability and spinal balance after ASD surgery. The present prospective study aimed to determine the recovery time of gait and spinal balance ability after adult spinal deformity (ASD) surgery. Patients with ASD (n = 25: mean age, 73.0 years) who underwent corrective surgery and preoperative and postoperative gait and spinal balance ability evaluation. Spinal radiographs and gait analysis data (static balance; single-leg standing, dynamic balance; time-up and go test, gait ability; 10 m walk velocity) were acquired preoperatively, 1 month, 6 months, and 12 months after surgery. The radiographic parameters of the spine and pelvis (lumbar lordosis; LL, pelvic tilt; PT, sagittal vertical axis; SVA, pelvic incidence; PI) were measured. The mean postoperative SVA, LL, PT, and PI-LL became 30.0 mm, 50.1 degrees, 14.1 degrees, and 0.35 degrees, respectively. Preoperatively, all spinal balance and gait ability were worse than the normal threshold (one-leg standing; 14.2 s vs. 15.0 s, time-up and go test; 13.9 s vs. 13.5 s, 10-m walk speed; 0.91 m/s vs. 1.00 m/s). At 12 months after surgery, all spinal balance and gait ability became normal or improved (single-leg standing; 14.7 s, time-up and go test; 11.0 s, 10-m walk speed; 1.09 m/s). The ODI at one-year follow-up improved from 46.8 ± 12.6% to 27.8 ± 18.1%. In conclusion, gait and spinal balance analysis revealed that ASD patients could not recover gait and spinal balance ability one month after surgery. At 12 months after surgery, gait ability and dynamic spinal balance became better than preoperative levels. However, the static spinal balance was at the same level as that of preoperative status.

Background and Objectives: Gait ability and spinal postural balance affect ADL in patients who underwent adult spinal deformity (ASD) surgery. However, it is still unclear how to determine what the cause is. This study was done to investigate various factors affecting gait, postural balance and activities of daily living (ADL) in patients who were operated on for ASD over a period of one year, following corrective surgery. Materials and Method: A cohort of 42 (2 men, 40 women, mean age, 71.1 years) who were operated on for ASD were included in this study. According to Oswestry Disability Index (ODI), based on their ADL, patients were segregated into satisfied and unsatisfied groups. Gait and postural balance abilities were evaluated before and after the operative procedure. Radiographs of spine and pelvis as well as the rehabilitation data (static balance, standing on single-leg; dynamic postural adaptation, timed up and go test (TUG); Gait Capability, walk velocity for a distance of 10 m) were acquired 12 months after surgery and analyzed. Spinopelvic parameters such as (lumbar lordosis (LL), pelvic tilt (PT), sagittal vertical axis (SVA), pelvic incidence (PI)) were marked and noted. The factors which affect patients’ satisfaction with their ADL were evaluated. Results: The ADL satisfied group included 18 patients (1 man, 17 women, mean age 68.6 years) and the unsatisfied group included 24 patients (1 man, 23 women, mean age 73.1 years). One year after the surgery, the two groups were tested. TUG (8.5 s vs. 12.8 s), 10 m walk velocity (1.26 m/s vs. 1.01 m/s), and single leg standing test (25 s vs. 12.8 s) were regarded as notably different. According to logistic regression analysis, only TUG was extracted as a significant factor. The cut-off value was 9.7 s, with sensitivity 75%, specificity 83%, area under the curve 0.824, and a 95% confidence interval of 0.695–0.953. Conclusions: A significant factor among all evaluations in postoperative ASD patients was TUG, for which the cut-off value for ADL satisfaction was 9.7 s.

Damage to the fascia can cause significant performance deficits in high-performance sports and recreational exercise and may contribute to the development of musculoskeletal disorders and persistent potential pain. The fascia is widely distributed from head to toe, encompassing muscles, bones, blood vessels, nerves, and internal organs and comprising various layers of different depths, indicating the complexity of its pathogenesis. It is a connective tissue composed of irregularly arranged collagen fibers, distinctly different from the regularly arranged collagen fibers found in tendons, ligaments, or periosteum, and mechanical changes in the fascia (stiffness or tension) can produce changes in its connective tissue that can cause pain. While these mechanical changes induce inflammation associated with mechanical loading, they are also affected by biochemical influences such as aging, sex hormones, and obesity. Therefore, this paper will review the current state of knowledge on the molecular level response to the mechanical properties of the fascia and its response to other physiological challenges, including mechanical changes, innervation, injury, and aging; imaging techniques available to study the fascial system; and therapeutic interventions targeting fascial tissue in sports medicine. This article aims to summarize contemporary views.