Does the type of sagittal spinal shape influence the clinical results of lumbar disc arthroplasty?

Laouissat, Féthi; Scemama, Caroline; Delécrin, J.

doi:10.1016/j.otsr.2016.05.012

Cited by 15 publications

(6 citation statements)

References 31 publications

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“…[ 19 ] Recent research highlights a relationship between these different spine types and clinical outcomes following lumbar disc arthroplasty, suggesting that variation in the inflection point between spinal curves could be an important consideration in indicating patients for surgery. [ 20 ] Although classification systems exist in the literature to describe the sagittal profiles of patients with different types of CD, these frameworks do not incorporate assessments of the cervicothoracic inflection point. [ 21 ] The results of this study show significant variations in sagittal alignment across inflection point groups, suggesting a potential rationale for modifying existing CD classification systems to incorporate inflection point.…”

Section: Discussionmentioning

confidence: 99%

Radiographic benefit of incorporating the inflection between the cervical and thoracic curves in fusion constructs for surgical cervical deformity patients

Bortz

Passias

Pierce

et al. 2020

J Craniovert Jun Spine

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Purpose: The aim is to assess the relationship between cervicothoracic inflection point and baseline disability, as well as the relationship between clinical outcomes and pre- to postoperative changes in inflection point. Methods: Cervical deformity (CD) patients with baseline and 3-month (3M) postoperative radiographic, clinical, and inflection data were grouped by region of inflection point: C6 or above, C6-C7 to C7-T1, T1, or below. Inflection was defined as: Distal-most level where cervical lordosis (CL) changes to thoracic kyphosis (TK). Differences in alignment and patient factors across pre- and postoperative inflection point groups were assessed, as were outcomes by the inclusion of inflection in the CD-corrective fusion construct. Results: A total of 108 patients were included. Preoperative inflection breakdown: C6 or above (42%), C6-C7 to C7-T1 (44%), T1 or below (15%). Surgery was associated with a caudal migration of inflection by 3M: C6 or above (8%), C6-C7 to C7-T1 (58%), T1 or below (33%). For patients with preoperative inflection T1 or below, the inclusion of inflection in the fusion construct was associated with improvements in horizontal gaze (McGregor's Slope included: −11.3° vs. not included: 1.6°, P = 0.038). The inclusion of preoperative inflection in fusion was associated with the superior cervical sagittal vertical axis (cSVA) changes for C6-C7 to C7-T1 patients (−5.2 mm vs. 3.2 mm, P = 0.018). The location of postoperative inflection was associated with variation in 3M alignment: Inflection C6 or above was associated with less Pelvic Tilt (PT), PT and a trend of larger cSVA. Location of inflection or inclusion in fusion was not associated with reoperation or distal junctional kyphosis. Conclusions: Incorporating the inflection point between CL and TK in the fusion construct was associated with superior restoration of cervical alignment and horizontal gaze for surgical CD patients.

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Section: Discussionmentioning

confidence: 99%

Radiographic benefit of incorporating the inflection between the cervical and thoracic curves in fusion constructs for surgical cervical deformity patients

Bortz

Passias

Pierce

et al. 2020

J Craniovert Jun Spine

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“…Arunakul et al [310] found no association between radiological features such as pelvic incidence and sacral slope, and clinical outcomes measured by back pain (VAS) and function (ODI) after TDR. In contrast, Laouissat et al [311] reported inferior results after TDR in patients with sagittal curvature of Roussouly type 4 [312].…”

Section: Exposure Variablesmentioning

confidence: 92%

Total disc replacement versus multidisciplinary rehabilitation in patients with chronic low back pain and degenerative discs: 8-year follow-up of a randomized controlled multicenter trial

et al. 2017

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“…As a result, the Roussouly classification has become one of the most widely used classification systems since 2005, when it was first reported. Many studies have proven the effects of the classification system on surgical decisions and outcomes [9,10,11] . In addition, studies have assessed the correlation between the morbidity of spine disorders and different Roussouly types.…”

Section: The Roussouly Classification Is Based On Features Of Spine Mmentioning

confidence: 99%

The characteristics of lumbar paraspinal muscle degeneration based on the Roussouly classification: a retrospective study

Yang

Zou

et al. 2020

Preprint

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Background: To analyse the characteristics of lumbar paraspinal muscle degeneration in individuals with different Roussouly types.Methods: Eighty patients (20 patients for each Roussouly type) with degenerative lumbar disease were retrospectively enrolled from January 2017 to February 2018. The cross-sectional area (CSA) and percentage of fat infiltration (FI) of the paraspinal muscles at the L1-S1 levels were measured using T2-weighted axial MRI and ImageJ software. The measured data were analysed with independent samples t-tests.Results: Degeneration of the paraspinal muscles of the upper lumbar region was significantly severer in Type 1 than in Type 3, the degrees of paraspinal muscle degeneration of Type 2 appeared to be more evenly distributed in all segments than Type 3, and Type 4 showed severer degeneration in L5-S1 than Type 3.Conclusion: The degree of paraspinal muscle degeneration in each segment was different across the four Roussouly types, but the degrees of degeneration were consistent with the characteristics of degenerative disease within each type.

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Does the type of sagittal spinal shape influence the clinical results of lumbar disc arthroplasty?

Cited by 15 publications

References 31 publications

Radiographic benefit of incorporating the inflection between the cervical and thoracic curves in fusion constructs for surgical cervical deformity patients

Radiographic benefit of incorporating the inflection between the cervical and thoracic curves in fusion constructs for surgical cervical deformity patients

Total disc replacement versus multidisciplinary rehabilitation in patients with chronic low back pain and degenerative discs: 8-year follow-up of a randomized controlled multicenter trial

The characteristics of lumbar paraspinal muscle degeneration based on the Roussouly classification: a retrospective study

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