KMID : 0388720050120040316
|
|
Journal of Korean Society of Spine Surgery 2005 Volume.12 No. 4 p.316 ~ p.323
|
|
Factors Affecting Segmental Lordotic Angle After Posterior Lumbar Interbody Fusion Using Metal Cage
|
|
Kim Eung-Ha
Lee Jung-Hee Shin Dong-Hoon Kim Young-Eun Je Han-Woong
|
|
Abstract
|
|
|
Study Design:This is a retrospective study.
Objectives:We tried to find out what kind of factors affect the segmental lordotic angle improvement after performing posterior lumbar interbody (PLIF) fusion using a metal cage. The study was done using radiographic measurements.
Summary of the Literature Review: For degenerative spinal disease, PLIF with using a metal cage is an effective way to fuse and restore segmental lordosis of the lumbar spine.
Materials and Methods:The study included 104 patients (65 males, 39 females). Radiographs of the antero-posterior, lateral, flexion and extension views that were taken during the preoperative period and the follow-up 6 months were evaluated for the L4-5 segmental lordosis angle, cage invagination, cage position and disc height. Then, statistical analysis was performed using the Pearson method to determine which factors affected the segmental lordotic angle correction.
Results:The increase of the anterior disc height on the postoperative lateral radiograph (gamma=0.303, p<0.01) and the increase of lordosis on the preoperative extension radiograph (gamma=0.384, p<0.01) showed statistically positive correlation with the increase of the postoperative segmental lordosis angle. When comparing between the 4 degrees and 8 degrees cages, the more angle the cage had, the more segmental angle was restored and this was statistically correlated (P<0.05). However, the amount of segmental lordosis angle correction was not as much as the angle of the cage that was used. Other factors such as cage invagination and cage position didn¡¯t show statistical correlation.
Conclusions: Posterior lumbar interbody fusion using a metal cage is useful method for restoring the lumbar segmental lordosis angle only if the disc is flexible enough to be distracted (ED note: distracted is the word you want?) sufficiently intraoperatively or if it allows good segmental lordosis, as seen on the preoperative extension radiograph. Correction of the segmental lordosis angle using a wedged cage with a larger angle was not always satisfactory because it did not restore as much angle as the angle of cage that was used.
|
|
KEYWORD
|
|
Lumbar lordosis, Posterior lumbar interbody fusion, Metal cage, Segmental lordosis angle
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|