KMID : 1189320190130030395
|
|
Asian Spine Journal 2019 Volume.13 No. 3 p.395 ~ p.402
|
|
Comparative Radiographic Outcomes of Lateral and Posterior Lumbar Interbody Fusion in the Treatment of Degenerative Lumbar Kyphosis
|
|
Nakashima Hiroaki
Kanemura Tokumi Satake Kotaro Ishikawa Yoshimoto Ouchida Jun Segi Naoki Yamaguchi Hidetoshi Imagama Shiro
|
|
Abstract
|
|
|
Study Design: Retrospective case?control study.
Purpose: To compare surgical invasiveness and radiological outcomes between posterior lumbar interbody fusion (PLIF) and lateral lumbar interbody fusion (LLIF) for degenerative lumbar kyphosis.
Overview of Literature: LLIF is a minimally invasive interbody fusion technique; however, few reports compared the clinical outcomes of conventional PLIF and LLIF for degenerative lumbar kyphosis.
Methods: Radiographic data for patients who have undergone lumbar interbody fusion (¡Ã3 levels) using PLIF or LLIF for degenerative lumbar kyphosis (lumbar lordosis [LL] <20¡Æ) were retrospectively examined. The following radiographic parameters were retrospectively evaluated preoperatively and 2 years postoperatively: segmental lordotic angle, LL, pelvic tilt (PT), pelvic incidence (PI), C7 sagittal vertical axis, and T1 pelvic angle.
Results: Nineteen consecutive cases with PLIF and 27 cases with LLIF were included. There were no significant differences in patients¡¯ backgrounds or preoperative radiographic parameters between the PLIF and the LLIF groups. The mean fusion level was 5.5¡¾2.5 levels and 5.8¡¾2.5 levels in the PLIF and LLIF groups, respectively (p=0.69). Although there was no significant difference in surgical times (p=0.58), the estimated blood loss was significantly greater in the PLIF group (p<0.001). Two years postoperatively, comparing the PLIF and LLIF groups, the segmental lordotic angle achieved (7.4¡Æ¡¾7.6¡Æ and 10.6¡Æ¡¾9.4¡Æ, respectively; p=0.03), LL (27.8¡Æ¡¾13.9¡Æ and 39.2¡Æ¡¾12.7¡Æ, respectively; p=0.006), PI?LL (19.8¡Æ¡¾14.8¡Æ and 3.1¡Æ¡¾17.5¡Æ, respectively; p=0.002), and PT (22.6¡Æ¡¾7.1¡Æ and 14.2¡Æ¡¾13.9¡Æ, respectively; p=0.02) were significantly better in the LLIF group.
Conclusions: LLIF provided significantly better sagittal alignment restoration in the context of degenerative lumbar kyphosis, with less blood loss.
|
|
KEYWORD
|
|
Lateral lumbar interbody fusion, Posterior lumbar interbody fusion, Minimally invasive surgical procedures, Global sagittal alignment, Local sagittal alignment
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|