Restoration of the spinopelvic sagittal balance in isthmic spondylolisthesis: posterior lumbar interbody fusion may be better than posterolateral fusion

Feng, Yu; Chen, Liang; Gu, Yun; Zhang, Zhiming; Yang, Huilin; Tang, Tianyi

doi:10.1016/j.spinee.2015.02.036

Cited by 32 publications

(18 citation statements)

References 47 publications

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“…The increase of lumbar lordosis and decrease of pelvic tilt may play an important role in better surgical outcome. A recent study showed that PLIF could restore the sagittal balance better than posterolateral fusion [ 25 ]. However, it is important to mention that the literature on lumbar fusion is primarily retrospective and heterogeneous with respect to indications, techniques and outcome measures.…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiological outcome of minimally invasive posterior lumbar interbody fusion in primary versus revision surgery

et al. 2016

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PurposeThe aim of this study is to compare the clinical and radiological outcome of minimally invasive posterior lumbar interbody fusion (MI-PLIF) in revision and primary cases.MethodsIn a retrospective study, we compared the clinical and radiological results of MI-PLIF for lytic spondylolisthesis (n = 28) and recurrent radiculopathy after herniated disc surgery (n = 28). Clinical outcome was assessed using the visual analogue score (VAS) and Oswestry Disability Index (ODI). Quality of life was assessed with the Euroqol-5d (EQ5D), the EQ5D VAS and the WHOQOL-BREF.ResultsThe follow-up was 5.1 (SD 2.3) years. The decrease in VAS scores was significant and comparable in both groups. We found significantly better ODI and quality of life scores for the patients with lytic spondylolisthesis. The radiological outcome showed only one non-union, and subsidence occurred in both groups at an equal amount.ConclusionThe MI-PLIF technique is a safe procedure with only few complications and a high fusion rate. It was successful in both groups, but the quality of life and ODI are better in primary cases.

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Section: Discussionmentioning

confidence: 99%

Clinical and radiological outcome of minimally invasive posterior lumbar interbody fusion in primary versus revision surgery

et al. 2016

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“…In recent years, spinopelvic sagittal balance is widely recognized as a crucial factor regulating clinical outcomes in patients undergoing spinal surgery [ 4 ] . Since lumbar spondylolisthesis often combines with other deformities like forward slip and kyphosis, it often results in a global sagittal imbalance of the spine.…”

Section: Introductionmentioning

confidence: 99%

A retrospective comparative study of postoperative sagittal balance in isthmic L5–S1 spondylolisthesis using single segment or two-segment pedicle screw fixation

Shao

Liu

et al. 2022

BMC Musculoskelet Disord

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Objective To compare the radiographic parameters and clinical outcomes of isthmic L5–S1 spondylolisthesis with single segment or two-segment pedicle screw fixation. Methods Between January 2018 and January 2019, a total of 76 patients with isthmic L5–S1 spondylolisthesis were included in this study. All patients were treated with varying numbers of pedicle screw fixation with single-segment fusion during posterior lumbar interbody fusion (PLIF). Patients were divided into two groups, based on the number of pedicle screws placed during fixation, namely, 4 screws (4S) group and 6 screws (6S) group. Subsequently, the sagittal balance parameters were measured, which included slippage degree (SD), lumbar lordosis (LL), segmental lordosis (SL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and sagittal vertical axis (SVA). Clinical functional outcomes were assessed using the visual analog scale (VAS) for back pain and the oswestry disability index (ODI) scores. Results The 4S group comprised of 10 males and 27 females, with a median age of 55.2 ± 10.8 years old and a mean follow-up of 16.95 ± 4.16 months. The 6S group comprised of 14 males and 25 females, with a median age of 58.1 ± 7.5 years old and a median follow-up of 17.33 ± 3.81 months. No significant differences were evident in all preoperative parameters between both groups. In contrast, the postoperative LL, SL, PT, SS, and SD values increased significantly, compared to the preoperative values in both groups (all P < 0.05). At the last follow-up, the 6S group exhibited better correction in LL, SL, and PT, relative to the 4S group (all P < 0.05). A significant SD difference was observed between both groups at all points post surgery (P < 0.05). The postoperative slip correction rate was significantly larger in the 6S group, compared to the 4S group (P < 0.05). The postoperative VAS and ODI scores of both groups improved significantly, when compared to the preoperative scores (both P < 0.05). However, there were no significant differences in the ODI and VAS scores between the two groups at all time points. Conclusions The clinical outcomes of both approaches appeared to be satisfactory. In terms of short-term outcomes, the 6S group exhibited better spinal sagittal restoration and stability than the 4S group.

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“…Park et al [19] reported that surgical correction of adult isthmic spondylolisthesis with posterior lumbar interbody fusion and posterior instrumentation resulted in improvement of sacral slope, pelvic tilt, lumber lordosis, and sagittal balance Pelvic parameters and sagittal balance changed subsequently. Sacral slope was increased by 4.4 degrees and pelvic tilt was decreased by 4.4 degrees and sagittal balance was displaced 5.6 mm posteriorly.Feng et al [20] reported that no significant difference can be found between the parameters of the posterolateral fusion and posterior lumbar interbody fusion. The two different operations can reduce the PT of the patients with spondylolisthesis.…”

Section: Discussionmentioning

confidence: 98%

Assessment of Pelvic Parameters before and after Postero-Lateral Interbody Fusion Surgery in Patient with Lumbo-Sacral Instability

Elhafez¹,

Negm²,

Ramadan³

2018

Egyptian Journal of Hospital Medicine

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Background: pelvic incidence (PI) is a fundamental pelvic anatomic parameter that is specific and constant for each individual and determines pelvic orientation as well as the size of lumbar lordosis (LL). Pelvic incidence (PI) is a descriptor of pelvic morphology and not of pelvic orientation: therefore, its angular value is unaffected by changes in human posture. The pelvic tilt (PT) and the sacral slope (SS) are position-dependent variables and are very useful to characterize the spatial orientation of the pelvis. Pelvic incidence, sacral slope and pelvic tilt are particularly useful because it can be demonstrated that pelvic incidence (PI) is the arithmetic sum of the sacral slope (SS) + pelvic tilt (PT). Objective: this study aimed to determine the effect of Postero-Lateral Inter Body Fusion Surgery (PLIF) in 25 patients with Lumbo-Sacral instability by measuring these three pelvic parameters by plain x-ray before and after surgery. Patients and Methods: when compared to normal populations, pelvic incidence (PI) is significantly higher in spondylolisthesis and the difference in PI tends to increase in a direct linear fashion as severity of the spondylolisthesis increases. The cause effect relationship between pelvic morphology and spondylolisthesis remains to be clarified. Taking into consideration the pelvic parameters stimulated a renewed interest for the radiological evaluation and classification of spino-pelvic alignment in L5-S1 spondylolisthesis. Results: we found that Postero-Lateral Inter Body Fusion Surgery (PLIF) is sucssessful operation for treatment of lumbo sacral instability such as degenerative spondylolisthesis, isthmic spondylolisthesis and post laminectomy instability. In comparison with lateral view x-ray before and after the operation, the pelvic incidence increased and pelvic tilt decreased. Conclusion: PLIF is successfully used to treat degenerative and isthmic spondylolisthesis. PLIF is successful regardless of age, sex and concomitant morbidities such as diabetes mellitus, hypertension and ischemic heart disease.

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Restoration of the spinopelvic sagittal balance in isthmic spondylolisthesis: posterior lumbar interbody fusion may be better than posterolateral fusion

Cited by 32 publications

References 47 publications

Clinical and radiological outcome of minimally invasive posterior lumbar interbody fusion in primary versus revision surgery

Clinical and radiological outcome of minimally invasive posterior lumbar interbody fusion in primary versus revision surgery

A retrospective comparative study of postoperative sagittal balance in isthmic L5–S1 spondylolisthesis using single segment or two-segment pedicle screw fixation

Assessment of Pelvic Parameters before and after Postero-Lateral Interbody Fusion Surgery in Patient with Lumbo-Sacral Instability

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