Relationship between lumbar lordosis, pelvic parameters, PI-LL mismatch and outcome after short fusion surgery for lumbar degenerative disease. Literature review, rational and presentation of public study protocol: RELApSE study (registry for evaluation of lumbar arthrodesis sagittal alignEment)

Tartara, Fulvio; Garbossa, Diego; Armocida, Daniele; Perna, Giuseppe Di; Ajello, Marco; Marengo, Nicola; Bozzaro, Marco; Petrone, Salvatore; Giorgi, Pietro Domenico; Schirò, Giuseppe; Legrenzi, Simona; Boeris, Davide; Piazzolla, Andrea; Passarelli, Anna Claudia; Longo, Alessandro; Ducati, Alessandro; Penner, Federica; Tancioni, Flavio; Bona, Alberto; Paternò, Giovanni; Tassorelli, Cristina; Icco, Roberto De; Lamaida, Giovanni Andrea; Gallazzi, Enrico; Pilloni, Giulia; Colombo, Elena; Gaetani, Paolo; Aimar, Enrico; Zoia, Cesare; Stefini, Roberto; Rusconi, Angelo; Querenghi, Amos M.; Brembilla, Carlo; Bernucci, Claudio; Fanti, Andrea; Frati, Alessandro; Manelli, Antonio; Muzii, Vitaliano; Sedia, Mattia; Romano, Alberto; Baram, Ali; Figini, Silvia; Ballante, Elena; Gioia, Giuseppe Di; Locatelli, Marco; Pluderi, Mauro; Morselli, Carlotta; Bassani, Roberto; Costa, Francesco; Cofano, Fabio

doi:10.1016/j.wnsx.2023.100162

Cited by 11 publications

(5 citation statements)

References 93 publications

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“…A recent review article analysed the relationships between clinical outcomes and restoration of sagittal alignment, pelvic parameters and spinopelvic mismatch. 40 The data in the studies that this paper reviewed were quite varied and the perceived relationships between spinal positioning parameters and clinical outcomes were not well aligned. This resulted in no conclusions or guidelines coming out of an extensive analysis.…”

Section: Discussionmentioning

confidence: 97%

24-Month Outcomes of Indirect Decompression Using a Minimally Invasive Interspinous Fixation Device versus Standard Open Direct Decompression for Lumbar Spinal Stenosis: A Prospective Comparison

Baranidharan,

Bretherton,

Feltbower

et al. 2024

JPR

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Section: Discussionmentioning

confidence: 97%

24-Month Outcomes of Indirect Decompression Using a Minimally Invasive Interspinous Fixation Device versus Standard Open Direct Decompression for Lumbar Spinal Stenosis: A Prospective Comparison

Baranidharan,

Bretherton,

Feltbower

et al. 2024

JPR

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“…There was a wide spectrum of patients in the current study, but with a high fusion rate there was insufficient numbers of patients with failed fusions to look at differences in fusion grades corresponding to specific spinal pathologies, amount of pre-surgical listhesis, and patient demographics. Despite the varied evidence and lack of conclusions or guidelines from a recent review article on the relationships between clinical outcomes and restoration of sagittal alignment, pelvic parameters and spinopelvic mismatch, 28 spinal positioning in lumbar arthrodesis remains an area for concern. Therefore, the influence of the indirect, distractive decompression of interspinous fixation devices on clinical outcomes beyond initial relief of symptoms associated with lumbar stenosis should be investigated.…”

Section: Limitations Of the Studymentioning

confidence: 99%

Instrumented Posterior Arthrodesis of the Lumbar Spine: Prospective Study Evaluating Fusion Outcomes in Patients Receiving an Interspinous Fixation Device for the Treatment of Degenerative Spine Diseases

Skoblar,

Hedman,

Rogers

et al. 2023

JPR

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Purpose Prospective evaluation of radiographic fusion outcomes in patients receiving instrumented posterior arthrodesis of the lumbar spine using a minimally invasive interspinous fixation device. Patients and Methods All patients (n = 110) from a single US physician’s practice who received instrumented posterior arthrodesis of the lumbar spine with a minimally invasive interspinous fixation device in the calendar year 2020 were invited to return for a follow-up CT scan to radiographically assess fusion. Forty-three patients, representing 69 total treated levels, consented to participate and received a lumbar CT scan at a mean of 459 days post-surgery (177 to 652). The interspinous/interlaminar fusion was assessed by 3 independent radiologists using a novel grading scale. Spinous process fractures were also assessed. Results 92.8% of the assessed levels were considered fused. There were no intraoperative spinous process fractures. There were 4 spinous process fractures (5.8%) identified on CT imaging, all of which were asymptomatic and healed without subsequent intervention. There were no instances of device mechanical failure or device-related reoperation. Conclusion Instrumented posterior arthrodesis of the lumbar spine using a minimally invasive interspinous fixation device provides clinically meaningful fusion rates with no reoperations and a low risk of spinous process fracture or other device-related complications.

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“…According to research, low back pain is associated with lumbosacral instability ( Panjabi, 2003 ). While many studies have focused on the treatment and prevention of lumbar diseases, there has been a shift toward researching the role of the lumbosacral sagittal alignment in lower back pain and lumbar diseases, emphasizing the importance of accurately measuring lumbosacral radiographic parameters ( Kalidindi et al, 2022 ; Tartara et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence automatic measurement technology of lumbosacral radiographic parameters

Yuan,

Chen,

Liu

et al. 2024

Front. Bioeng. Biotechnol.

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BackgroundCurrently, manual measurement of lumbosacral radiological parameters is time-consuming and laborious, and inevitably produces considerable variability. This study aimed to develop and evaluate a deep learning-based model for automatically measuring lumbosacral radiographic parameters on lateral lumbar radiographs.MethodsWe retrospectively collected 1,240 lateral lumbar radiographs to train the model. The included images were randomly divided into training, validation, and test sets in a ratio of approximately 8:1:1 for model training, fine-tuning, and performance evaluation, respectively. The parameters measured in this study were lumbar lordosis (LL), sacral horizontal angle (SHA), intervertebral space angle (ISA) at L4–L5 and L5–S1 segments, and the percentage of lumbar spondylolisthesis (PLS) at L4–L5 and L5–S1 segments. The model identified key points using image segmentation results and calculated measurements. The average results of key points annotated by the three spine surgeons were used as the reference standard. The model’s performance was evaluated using the percentage of correct key points (PCK), intra-class correlation coefficient (ICC), Pearson correlation coefficient (r), mean absolute error (MAE), root mean square error (RMSE), and box plots.ResultsThe model’s mean differences from the reference standard for LL, SHA, ISA (L4–L5), ISA (L5–S1), PLS (L4–L5), and PLS (L5–S1) were 1.69°, 1.36°, 1.55°, 1.90°, 1.60%, and 2.43%, respectively. When compared with the reference standard, the measurements of the model had better correlation and consistency (LL, SHA, and ISA: ICC = 0.91–0.97, r = 0.91–0.96, MAE = 1.89–2.47, RMSE = 2.32–3.12; PLS: ICC = 0.90–0.92, r = 0.90–0.91, MAE = 1.95–2.93, RMSE = 2.52–3.70), and the differences between them were not statistically significant (p > 0.05).ConclusionThe model developed in this study could correctly identify key vertebral points on lateral lumbar radiographs and automatically calculate lumbosacral radiographic parameters. The measurement results of the model had good consistency and reliability compared to manual measurements. With additional training and optimization, this technology holds promise for future measurements in clinical practice and analysis of large datasets.

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Relationship between lumbar lordosis, pelvic parameters, PI-LL mismatch and outcome after short fusion surgery for lumbar degenerative disease. Literature review, rational and presentation of public study protocol: RELApSE study (registry for evaluation of lumbar arthrodesis sagittal alignEment)

Cited by 11 publications

References 93 publications

24-Month Outcomes of Indirect Decompression Using a Minimally Invasive Interspinous Fixation Device versus Standard Open Direct Decompression for Lumbar Spinal Stenosis: A Prospective Comparison

24-Month Outcomes of Indirect Decompression Using a Minimally Invasive Interspinous Fixation Device versus Standard Open Direct Decompression for Lumbar Spinal Stenosis: A Prospective Comparison

Instrumented Posterior Arthrodesis of the Lumbar Spine: Prospective Study Evaluating Fusion Outcomes in Patients Receiving an Interspinous Fixation Device for the Treatment of Degenerative Spine Diseases

Artificial intelligence automatic measurement technology of lumbosacral radiographic parameters

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