Comparison of posterolateral fusion and posterior lumbar interbody fusion for treatment of degenerative spondylolisthesis: Analysis of spino-pelvic sagittal balance and postoperative chronic low back pain

Zhang, Yi-Jian; Liu, Hao; Yang, Huilin; Pi, Bin

doi:10.1016/j.clineuro.2018.04.020

Cited by 15 publications

(14 citation statements)

References 24 publications

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“…However, the spinopelvic parameters were significantly restored only in the posterior lumbar interbody fusion group. Also, this group revealed less incidence of postoperative chronic low-back pain [16]. The results of this study supported the positive effect of interbody fusion on the spinopelvic parameters and the pain level of the SL patients.…”

Section: Discussionsupporting

confidence: 83%

Improvement of Spinopelvic Parameters Following the Surgical Treatment of Spondylolisthesis Using Interbody Fusion Cage

Ghandhari

Nikouei

Chehrassan

et al. 2020

J. Res. Orthop. Sci.

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Background: There is no consensus regarding the clinical benefit of interbody fusion cage in the treatment of Spondylolisthesis (SL). This study aimed to evaluate the effect of posterolateral fusion combined with interbody fusion cage on the spinopelvic parameters and the pain level of the patients. Objectives: Role of interbody fusion in the treatment of spondylolisthesis Methods: This prospective study included 40 SL patients who underwent surgery following the failure of conservative management. The Meyerding classification was used to grade SL. Also, the visual analog scale was used to measure the level of pain, before and after the operation. Spinopelvic parameters included total kyphosis, sagittal vertebral axis, pelvic tilt, pelvic incidence, and lumbar lordosis. Results: The Mean±SD age of the patients was of 53.4±11.6 years. In four patients (10%), SL occurred at two levels. Besides, the etiology was degenerative in 21 cases (52.5%) and isthmic in 19 cases (47.5%). The grade I, II, and III of SL were detected respectively in 17, 17, and 6 cases (42.5%, 42.5%, and 15%, respectively). The Mean±SD preoperative value of the sagittal vertebral axis was 43.1±33.1 mm, which improved to 24.8±22.3 mm after the surgery (P<0.001). Also, the Mean±SD preoperative value of the pelvic tilt significantly improved from 19.2±10º to 17±9.1º (P=0.049). Moreover, the Mean±SD score of the visual analog scale improved from 9.1±0.8 to 2.8±1.2 (P<0.001). The clinical and spinopelvic parameters greatly improved in patients with degenerative SLs, single-level SLs, and the lower grades of SL. Conclusion: Posterolateral fusion combined with interbody fusion cage improves both the clinical and spinopelvic parameters of SL patients and could be suggested as the treatment of choice for these patients.

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Section: Discussionsupporting

confidence: 83%

Improvement of Spinopelvic Parameters Following the Surgical Treatment of Spondylolisthesis Using Interbody Fusion Cage

Ghandhari

Nikouei

Chehrassan

et al. 2020

J. Res. Orthop. Sci.

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“…However, long-term use of these drugs can cause many adverse effects, such as gastrointestinal reactions and cardiovascular events ( 9 , 10 ). Furthermore, surgical therapy often brings sequelae, such as postoperative CLBP and surgical failure ( 11 , 12 ), so many refuse surgical therapy. Therefore, many doctors and patients are often looking for more effective ways to treat CLBP.…”

Section: Introductionmentioning

confidence: 99%

Myofascial Release for Chronic Low Back Pain: A Systematic Review and Meta-Analysis

Wang

et al. 2021

Front. Med.

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Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal diseases in the elderly, which has a severe impact on the health of the elderly. However, CLBP treatment is very challenging, and more effective treatment methods are needed. Myofascial release may be an effective therapy for the management of chronic musculoskeletal pain. It is widely used clinically to treat CLBP, but its clinical efficacy is still controversial.Objective: This study aims to systematically evaluate the effectiveness of myofascial release for patients with CLBP.Methods: We selected PubMed, Cochrane Library, EMBASE database, and Web of Science database articles published until April 5, 2021. Randomized controlled trials (RCTs) of myofascial release for CLBP were included. Outcome measures included pain, physical function, quality of life, balance function, pain pressure-threshold, trunk mobility, and mental health. For each outcome, Standardized mean differences (SMD) or mean differences (MD) and 95% confidence intervals (CIs) were calculated.Results: Eight RCTs (n = 375) were included based on inclusion and exclusion criteria. The meta-analysis showed that the overall efficacy of myofascial release for CLBP was significant, including two aspects: pain [SMD = −0.37, 95% CI (−0.67, −0.08), I2 = 46%, P = 0.01] and physical function [SMD = −0.43, 95% CI (−0.75, −0.12), I2 = 44%, P = 0.007]. However, myofascial release did not significantly improve quality of life [SMD = 0.13, 95% CI (−0.38, 0.64), I2 = 53%, P = 0.62], balance function [SMD = 0.58, 95% CI (−0.49, 1.64), I2 = 82%, P = 0.29], pain pressure-threshold [SMD = 0.03,95% CI (−0.75, 0.69), I2 = 73%, P = 0.93], trunk mobility [SMD = 1.02, 95% CI (−0.09, 2.13), I2 = 92%, P = 0.07] and mental health [SMD = −0.06, 95% CI (−0.83, 0.71), I2 = 73%, P = 0.88].Conclusions: In this study, we systematically reviewed and quantified the efficacy of myofascial release in treating CLBP. The meta-analysis results showed that myofascial release significantly improved pain and physical function in patients with CLBP but had no significant effects on balance function, pain pressure-threshold, trunk mobility, mental health, and quality of life. However, due to the low quality and a small number of included literature, more and more rigorously designed RCTs should be included in the future to verify these conclusions.

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“…A retrospective study comparing the outcomes between TLIF and PLF found that the PLF construct was more prone to induce instrument breakage and pseudoarthrosis compared with the TLIF technique, indicating the importance of anterior column support in the maintenance of construct stability [29]. In recent years, TLIF has replaced PLF to be the most commonly used lumbar fusion surgery [30]. However, postoperative screw loosening was not completely avoided, especially in patients undergoing long segment pedicle screw xation [5].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Predictive Factors of Distal Pedicle Screw Loosening Followed Posterior Corrective Surgery for Degenerative Lumbar Scoliosis

Wang¹,

Wang²,

Sun³

et al. 2021

Preprint

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BackgroundThe aim of this study was to identify the prevalence of distal pedicle screw loosening (DPSL) following posterior decompression and instrumented fusion for DLS, to search for predictable risk factors for DPSL, and hope to provide references in decision making and surgical planning for spine surgeons. MethodsOne hundred and fifty-three consecutive DLS patients surgically treated between January 2013 and July 2018 were retrospectively reviewed. The diagnostic criteria for DPSL developed by X-ray include the radiolucent area (thicker than 1 mm) around screw and the “double halo” sign defined as the presence of radiolucent area and radiopaque rim at the same X-ray. According to the occurrence of DPSL at two-year follow-up, patients were divided into two groups: study group (screw loosening) and control group (without screw loosening). To investigate predictive factors for distal pedicle screw loosening, three categorized factors were analyzed statistically.ResultsDPSL was detected in 72 of 153 patients (47.1%) at two-year follow up, and were enrolled as study group. Another 81 patients presented no screw loosening at two-year follow up, and were enrolled as control group. Hounsfield unit (HU) value was lower in study group than that in control group. Fusion level was longer in study group than that in control group. Lower instrumented vertebrae on L5 was less in study group than that in control group. Posterolateral fusion was less in study group than that in control group. Preoperative Cobb angle, postoperative Cobb angle, Cobb angle correction, preoperative lumbosacral coronal angle (LSCA), LSCA correction, preoperative thoracolumbar junction (TL), postoperative TL were larger in study group than those in control group. Logistic regression analysis revealed that low Bone mineral density (BMD) (<169 HU), posterolateral fusion, Cobb angle correction (>16 degrees), LSCA correction (>9 degrees) were independently associated with DPSL.ConclusionsThe incidence of DPSL following posterior decompression and instrumented fusion for DLS is 47.1%. Low BMD, large correction of both main curve and fractional curve are predictive factors for DPSL, while posterolateral fusion is a protective factor.

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Comparison of posterolateral fusion and posterior lumbar interbody fusion for treatment of degenerative spondylolisthesis: Analysis of spino-pelvic sagittal balance and postoperative chronic low back pain

Cited by 15 publications

References 24 publications

Improvement of Spinopelvic Parameters Following the Surgical Treatment of Spondylolisthesis Using Interbody Fusion Cage

Improvement of Spinopelvic Parameters Following the Surgical Treatment of Spondylolisthesis Using Interbody Fusion Cage

Myofascial Release for Chronic Low Back Pain: A Systematic Review and Meta-Analysis

Incidence and Predictive Factors of Distal Pedicle Screw Loosening Followed Posterior Corrective Surgery for Degenerative Lumbar Scoliosis

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