Lumbar spinal fusion of low-grade degenerative spondylolisthesis (Meyerding grade I and II): Do reduction and correction of the radiological sagittal parameters correlate with better clinical outcome?

Oikonomidis, Stavros; Meyer, Carolin; Scheyerer, Max Joseph; Grevenstein, David; Eysel, Peer; Bredow, Jan

doi:10.1007/s00402-019-03282-9

Cited by 24 publications

(11 citation statements)

References 26 publications

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“…By correlation of sagittal balance parameters to clinical outcome scores, we found correlation between sacral inclination, sacral slope and sagittal rotation to postoperative COMI and ODI scores at 3-year follow-up. Change was found in outcome of the 3-year follow-up data compared to our previously published 2-year follow-up [20].…”

Section: Discussioncontrasting

confidence: 50%

Clinical outcome after lumbar spinal fusion surgery in degenerative spondylolisthesis: a 3-year follow-up

Lenz

Oikonomidis

Hartwig

et al. 2020

Arch Orthop Trauma Surg

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Introduction Lumbar spinal fusion surgery is a widely accepted surgical treatment in degenerative causes of lumbar spondylolisthesis. The benefit of reduction of anterior displacement and restoration of sagittal parameters is still controversially debated. Purpose of the underlying publication was to analyze the influence of radiographic sagittal parameters of the spine in aspects of changes in postoperative clinical outcome. Materials and methods By prospective analysis, we included patients with low-grade degenerative lumbar spondylolisthesis (Meyerding grades I and II) with mono- or bisegmental fusion surgery with a minimum follow-up data of 3 years. For clinical outcome measures, COMI, ODI and EQ-5D were used. Spinopelvic parameters (sacral inclination, pelvic tilt, sacral slope and pelvic incidence, lumbar lordosis and lumbar index as well as anterior displacement and sagittal rotation) were measured on plain radiographs. Results We could observe a significant benefit in clinical outcome after lumbar fusion surgery in low-grade spondylolisthesis in our mid-term follow-up data including 32 patients. By surgical reduction, we could see significant restoration of anterior displacement and sagittal rotation. Interestingly, a significant correlation between restoration of both sagittal rotation and sacral inclination and clinical outcome score was observed in the 3-year follow-up. Conclusion In low-grade spondylolisthesis, spinal fusion surgery is a well-established surgical procedure; however, the impact of sagittal parameters and reduction of anterior displacement remains controversial. Within our findings, restoration of sagittal parameters showed significant correlation to improvement in clinical outcome in our mid-term follow-up data.

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Section: Discussioncontrasting

confidence: 50%

Clinical outcome after lumbar spinal fusion surgery in degenerative spondylolisthesis: a 3-year follow-up

Lenz

Oikonomidis

Hartwig

et al. 2020

Arch Orthop Trauma Surg

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“…5,6 However, the clinical significance of slip reduction in degenerative spondylolisthesis has not been clearly demonstrated. [4][5][6][7][8][9] Oblique lumbar interbody fusion (OLIF) is a recently introduced minimally invasive surgical technique that evolved from both anterior lumbar interbody fusion (ALIF) and direct lateral interbody fusion (DLIF). [10][11][12][13] OLIF has advantages over ALIF in that the larger lateral cage can achieve greater disc height restoration, indirect decompression, and angular correction.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Slip Reduction in Oblique Lumbar Interbody Fusion With Posterior Fixation for Degenerative Spondylolisthesis

Chung

Lee

Jeon

et al. 2021

Global Spine Journal

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Study Design: Retrospective case series Objectives: Reduction of translational/angular slip is a favorable radiological result in spinal fusion for degenerative spondylolisthesis, although its clinical significance remains controversial. Few studies have investigated slip reduction and associated factors in oblique lumbar interbody fusion (OLIF) for degenerative spondylolisthesis. Methods: This study involved a retrospective analysis of 56 operated levels of 52 consecutive patients who underwent OLIF for degenerative spondylolisthesis and had more than 1-year of regular follow-up. Translational/angular slip, anterior/posterior disc height, and spinopelvic parameters were measured preoperatively, postoperatively at 6-weeks, and at the last follow-up. Demographic, radiological, and surgical parameters were analyzed to determine factors associated with the amount of slip reduction. Result: The mean follow-up duration was 30.4 ± 12.9 months (range, 12 to 61). The mean decrease in translational slip was 5.7 ± 2.1 mm (13.6 ± 5.5%) and the mean increase in angular slip was 7.9 ± 7.1° at the last follow-up (both P < 0.001). The amount of slip reduction was greater in female sex, age < 65 years, use of a 12° cage, cage position from the anterior disc margin of < 7 mm, and cases with posterior decompression (laminectomy with inferior facetectomy). Conclusions: OLIF showed satisfactory translational/angular slip reduction in degenerative spondylolisthesis. Surgical techniques for optimal reduction include the use of a large angle cage, anterior cage placement, and resection of the inferior facet.

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“…Two years after surgery the clinical outcomes also improved significantly, but the three‐year data showed that the sagittal rotation did not correlate with the clinical outcome at that point of time. 39 The 3‐year follow‐up data did, however, show a correlation between the sacral slope and correlation of the sacral inclination and the COMI score. This 6‐year follow‐up did not show similar results regarding the correlation of the COMI and the sacral slope and the sacral inclination.…”

Section: Discussionmentioning

confidence: 86%

“…Previously published data of the same registry this study is referring to found that one year after surgery the increase of sagittal rotation correlated with a better clinical outcome as measured by COMI, ODI, and VAS. Two years after surgery the clinical outcomes also improved significantly, but the three‐year data showed that the sagittal rotation did not correlate with the clinical outcome at that point of time 39 . The 3‐year follow‐up data did, however, show a correlation between the sacral slope and correlation of the sacral inclination and the COMI score.…”

Section: Discussionmentioning

confidence: 89%

Long‐term Radiological and Clinical Outcome after Lumbar Spinal Fusion Surgery in Patients with Degenerative Spondylolisthesis: A Prospective 6‐Year Follow‐up Study

Bredow

Meyer

Oikonomidis

et al. 2022

Orthopaedic Surgery

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Objective To assess which radiological alignment parameters are associated with a satisfactory long‐term clinical outcome after performing lumbar spinal fusion for treating degenerative spondylolisthesis. Methods This single‐center prospective study assessed the relation between radiological alignment parameters measured on standing lateral lumbar spine radiographs and the patient‐reported outcome using four different questionnaires (COMI, EQ‐5D, ODI and VAS) as primary outcome measures (level of evidence: II). The following spinopelvic alignment parameters were used: gliding angle, sacral inclination, anterior displacement, sagittal rotation, lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence. Furthermore, the length of stay and perioperative complications were documented. Only cases from 2013 to 2015 of low‐grade degenerative lumbar spondylolisthesis (Meyerding grades I and II) were considered. The patients underwent open posterior lumbar fusion surgery by pedicle screw instrumentation and cage insertion. The operative technique was either a posterior lumbar interbody fusion (PLIF) or a transforaminal lumbar interbody fusion (TLIF) performed by three different senior orthopedic surgeons. Exclusion criteria were spine fractures, minimally invasive techniques, underlying malignant diseases or acute infections, previous or multisegmental spine surgery as well as preoperative neurologic impairment. Of 89 initially contacted patients, 17 patients were included for data analysis (11 males, six females). Results The data of 17 patients after mono‐ or bisegmental lumbar fusion surgery to treat low‐grade lumbar spondylolisthesis and with a follow‐up time of least 72 months were analyzed. The mean age was 66.7 ± 11.3 years. In terms of complications two dural tears and one intraoperative bleeding occurred. The average body mass index (BMI) was 27.6 ± 4.4 kg/m 2 and the average inpatient length of stay was 12.9 ± 3.8 days (range: 8–21). The long‐term clinical outcome correlated significantly with the change of the pelvic tilt ( r s = −0.515, P < 0.05) and the sagittal rotation ( r s = −0.545, P < 0.05). The sacral slope was significantly associated with the sacral inclination ( r s = 0.637, P < 0.01) and the pelvic incidence ( r s = 0.500, P < 0.05). In addition, the pelvic incidence showed a significant correlation with the pelvic tilt ( r s = 0.709, P < 0.01). The change of the different clinical scores over time also correlated significantly between the different questionnaires. Conclusions The surgical modification of the pelvic tilt and...

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Lumbar spinal fusion of low-grade degenerative spondylolisthesis (Meyerding grade I and II): Do reduction and correction of the radiological sagittal parameters correlate with better clinical outcome?

Cited by 24 publications

References 26 publications

Clinical outcome after lumbar spinal fusion surgery in degenerative spondylolisthesis: a 3-year follow-up

Clinical outcome after lumbar spinal fusion surgery in degenerative spondylolisthesis: a 3-year follow-up

Factors Affecting Slip Reduction in Oblique Lumbar Interbody Fusion With Posterior Fixation for Degenerative Spondylolisthesis

Long‐term Radiological and Clinical Outcome after Lumbar Spinal Fusion Surgery in Patients with Degenerative Spondylolisthesis: A Prospective 6‐Year Follow‐up Study

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