The Study: Failure to maintain segmental lordosis during TLIF for one-level degenerative spondylolisthesis negatively affects clinical outcome 5 years postoperatively: a prospective cohort of 57 patients
a. The authors wished to examine how lumbar lordosis (or segmental lordosis) following instrumented fusion affected the outcomes.
b. It was a prospective study.
c. The patients underwent surgery for degenerative spondylolisthesis.
d. The patients were evaluated postoperatively and one and five years later.
e. The authors found that under correction of segmental lordosis resulted to a forward shift of the sagittal vertical axis (SVA). This had a negative effect on the outcomes at the one and five year follow ups.
f. “In patients with low PI [pelvic incidence], postoperative decrease in lumbar lordosis negatively affects clinical results 5 years postoperatively.”
g. Because of this study the authors noted they had changed their surgical procedure to enable “the creation of maximal segmental lordosis.”
h. The authors stated: “As anticipated, SVA in our series was found a single most important determinant of clinical outcome with postoperative anterior shift negatively affecting clinical results”
Structural alignment is important to symptoms following this type of fusion.
Another study discussing the importance of structure to symptoms. I would like to thank Dr. Keith Rau for letting me know about this study.
Reviewer: Roger Coleman DC
Editor’s Comments: Lordosis good. No lordosis bad.
Editor: Mark R. Payne DC
Reference: Kuhta M, Bosnjak K, Vengust R. Failure to maintain segmental lordosis during TLIF for one-level degenerative spondylolisthesis negatively affects clinical outcome 5 years postoperatively: a prospective cohort of 57 patients. Eur Spine J. 2019 Apr;28(4):745-750. doi: 10.1007/s00586-019-05890-w. Epub 2019 Jan 24.
Link to Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30680634