Effects of Cage Implantation Depth on Sagittal Parameters and Functional Outcomes in Posterior Lumbar Interbody Fusion for the Treatment of L4‐L5 Lumbar Degenerative Spondylolisthesis

Autor: Lei Deng, Chengyue Wang, Haifu Sun, Nanning Lv, Yang Shen, Zhonglai Qian, Hao Liu
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Orthopaedic Surgery, Vol 16, Iss 6, Pp 1327-1335 (2024)
Druh dokumentu: article
ISSN: 1757-7861
1757-7853
DOI: 10.1111/os.14071
Popis: Objective In the treatment of lumbar degenerative spondylolisthesis (LDS) with Posterior lumbar interbody fusion (PLIF) surgery, interbody fusion implants play a key role in supporting the vertebral body and facilitating fusion. The objective of this study was to assess the impact of implantation depth on sagittal parameters and functional outcomes in patients undergoing PLIF surgery. Methods This study reviewed 128 patients with L4‐L5 LDS between January 2016 and August 2019. All patients underwent an open PLIF surgery that included intravertebral decompression, implantation of pedicle screws and cage. We grouped according to the position of the center of the cage relative to the L5 vertebral endplate. Patients with the center of the cage located at the anterior 1/2 of the upper end plate of the L5 vertebral body were divided into Anterior group, and located at the posterior 1/2 of the upper end plate of the L5 vertebral body were divided into Posterior group. The lumbar lordosis (LL), segmental lordosis (SL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT) and slope degree (SD) was measured for radiographic outcomes. We used the visual analog scale (VAS) and the oswestry disability index (ODI) score to assess functional outcomes. Paired t‐test was used to compare imaging and bedside data before and after surgery between the two groups, and independent sample t‐test, χ2 test and Fisher exact test were used to compare the data between the two groups. Result The mean follow‐up of Anterior group was 44.13 ± 9.23 months, and Posterior group was 45.62 ± 10.29 months (P > 0.05). The LL, SL, PT, SS, SD and PI‐LL after operation showed great improvements, relative to the corresponding preoperative values in both groups (P
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