Post-operative L5 radiculopathy after L5-S1 hyperlordotic anterior lumbar interbody fusion (HL-ALIF) is related to a greater increase of lordosis and smaller post-operative posterior disc height: results from a cohort study
| Autor: | Domenico Compagnone, Francesco Langella, Riccardo Cecchinato, Marco Damilano, Carmelo Messina, Luca Maria Sconfienza, Claudio Lamartina, Pedro Berjano |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Adult spine deformity Anterior lumbar interbody fusion (ALIF) Cohort study Complication Hyperlordotic cages Radicular pain Sagittal Imbalance Lumbar Vertebrae Pain Middle Aged Cohort Studies Cross-Sectional Studies Postoperative Complications Spinal Fusion Treatment Outcome Settore MED/36 - Diagnostica per Immagini e Radioterapia Lordosis Humans Orthopedics and Sports Medicine Surgery Radiculopathy Aged Retrospective Studies |
| Zdroj: | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 31(7) |
| ISSN: | 1432-0932 |
| Popis: | A single-centre retrospective study.This study aims to investigate the rate of L5 radiculopathy, to identify imaging features associated with the complication and to evaluate the clinical outcomes in adult spine deformity patients undergoing L5-S1 ALIF with hyperlordotic cages.Design: retrospective cohort study. A single-centre prospective database was queried to analyse patients undergoing hyperlordotic (HL) ALIF with posterior fusion to correct spinal deformity. Clinical status was evaluated by back and leg pain numeric rate scale and Oswestry Disability Index pre-operatively and at 3-, 6- and 12-month follow-up. Spinopelvic parameters, such as pelvic incidence, pelvic tilt, lumbar lordosis and L5-S1 lordosis, posterior disc height (PDH) and anterior disc height, were assessed pre-operatively and post-operatively on standardized full-spine standing EOS images. The sagittal foraminal area was measured pre- and post-operatively on a CT scan.Thirty-nine patients with a mean age of 63.2 ± 8.6 years underwent HL-ALIF from January 2016 to December 2019. Seven of them developed post-operative root pain (5) or weakness (2) (Group A), while thirty-two did not (Group B). Root impairment was associated with greater segmental correction magnitude, 26° ± 11.1 in Group A versus 15.1° ± 9.9 in Group B (p 0.05), and to smaller post-operative PDH, 5.9 mm ± 2.7 in Group A versus 8.3 mm ± 2.6 (p 0.05).Post-operative root problems were observed in 17.9% of patients undergoing HL-ALIF for adult spine deformity. L5 radiculopathy was associated with larger sagittal angular corrections and smaller post-operative posterior disc height. One patient (2.6%) needed L5 root decompression. At 12 months of follow-up, results were equivalent between groups.Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding. |
| Databáze: | OpenAIRE |
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