Comparison of Sagittal Contour and Posterior Disc Height Following Interbody Fusion
- 1 August 2005
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Spinal Disorders & Techniques
- Vol. 18 (4), 332-336
- https://doi.org/10.1097/01.bsd.0000163037.17634.89
Abstract
Segmental restoration of sagittal contour is recognized as critical for improved long-term success following instrumented lumbar fusions. As such, the use of wedged implants has become more popular. Few studies exist to assess the postoperative lordotic and disc height changes following these varied techniques in spinal fusion. An observational radiographic study examining lumbar sagittal contour and posterior intervertebral disc space height following posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) was conducted using vertical cages (VCs), wedged structural allograft (WSA), and threaded cylindrical cages (TCCs). Forty-nine consecutive patients (59 spinal segments) were evaluated following single- or two-level interbody fusion with either stand-alone TCCs (n = 18 levels), WSA with posterior transpedicular compression instrumentation (n = 25 levels), or VCs with posterior transpedicular compression instrumentation (n = 16 levels). Standing lumbar radiographs were measured by two independent observers preoperatively, immediately postoperatively (within 1 week), at 6-week follow-up (range 4-8 weeks), and postoperatively (at 1-year follow-up) for segmental lordosis at each level undergoing posterior interbody arthrodesis and posterior intervertebral disc space height to assess indirect nerve root decompression. At the 1-year follow-up, postoperative lordosis was improved in the VC group (+5.3 degrees ; P < 0.005), whereas it decreased in the WSA group (-0.9 degrees ; P = 0.407) and TCC group (-3.5 degrees ; P < 0.005). The posterior disc space height decreased in the VC group (-0.5 mm; P = 0.109), whereas it increased for both the WSA group (+1.2 mm; P = 0.05) and the TCC group (+0.8 mm; P = 0.219). PLIF with stand-alone TCC and PLIF (or TLIF) with WSA and posterior transpedicular instrumentation results in an increased posterior disc height and thus improved indirect nerve root decompression. PLIF (or TLIF) with VC and posterior transpedicular instrumentation results in an overall decrease in posterior disc height. However, TCC and WSA resulted in a loss of lumbar lordosis, whereas VC resulted in an increase in lumbar lordosis.Keywords
This publication has 21 references indexed in Scilit:
- Radiographic Spinal Profile Changes Induced by Cage Design After Posterior Lumbar Interbody FusionSpine, 2001
- Comparison of Posterior and Transforaminal Approaches to Lumbar Interbody FusionSpine, 2001
- Lumbar Sagittal Contour After Posterior Interbody FusionSpine, 2001
- Posterior Lumbar Interbody FusionSpine, 1997
- Interbody, Posterior, and Combined Lumbar FusionsSpine, 1995
- An Analysis of Sagittal Spinal Alignment in 100 Asymptomatic Middle and Older Aged VolunteersSpine, 1995
- Increasing Neuroforaminal Volume by Anterior Interbody Distraction in Degenerative Lumbar SpineSpine, 1995
- The Role of Distraction in Improving the Space Available in the Lumbar Stenotic Canal and ForamenSpine, 1994
- Biomechanics of Lumbar FusionPublished by Ovid Technologies (Wolters Kluwer Health) ,1985
- Posterior Lumbar Interbody Fusion UpdatedClinical Orthopaedics and Related Research, 1985