Universität zu Köln

Bredow, Jan, Meyer, Carolin, Oikonomidis, Stavros, Kernich, Constantin, Kernich, Nikolaus, Hofstetter, Christoph P., Heck, Vincent J., Eysel, Peer and Prasse, Tobias (2022). Long-term Radiological and Clinical Outcome after Lumbar Spinal Fusion Surgery in Patients with Degenerative Spondylolisthesis: A Prospective 6-Year Follow-up Study. Orthop. Surg., 14 (8). S. 1607 - 1615. HOBOKEN: WILEY. ISSN 1757-7861

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Abstract

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 the sagittal rotation are the two radiological alignment parameters that can most accurately predict the long-term clinical outcome after lumbar interbody fusion surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bredow, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Carolin UNSPECIFIED UNSPECIFIED UNSPECIFIED Oikonomidis, Stavros UNSPECIFIED UNSPECIFIED UNSPECIFIED Kernich, Constantin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kernich, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hofstetter, Christoph P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heck, Vincent J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, Peer UNSPECIFIED UNSPECIFIED UNSPECIFIED Prasse, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-677116
DOI:	10.1111/os.13350
Journal or Publication Title:	Orthop. Surg.
Volume:	14
Number:	8
Page Range:	S. 1607 - 1615
Date:	2022
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1757-7861
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SURGICAL-TREATMENT; SAGITTAL BALANCE; INTERBODY FUSION; REDUCTION; ALIGNMENT; DECOMPRESSION; PARAMETERS; TRENDS Multiple languages Orthopedics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67711