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Evaluation of lordosis recovery after lumbar arthrodesis and its clinical impact

Chinese Neurosurgical Journal 2023年第3期9卷 177-182页

作者： Gabriel Tchachoua Jiembou hermann adonis nda Meleine Landry Konan Department of Neurosurgery University Hospital of Toulouse31300 ToulouseFrance Department of Neurosurgery University Hospital Yopougon21 BP 632 AbidjanIvory Coast Training and Research Unit of Medical Sciences University Felix Houphouet Boigny01 BPV 34 AbidjanIvory Coast

Background Posterior lumbar arthrodesis has become a widely used therapeutic option to correct sagittal imbalances in patients suffering from degenerative lumbar conditions.However,in western Africa,there is no study have reported long-term outcome of posterior lumbar arthrodesis.The aim of this study was to investigate the relationship between the restoration of adequate lordosis and the patient’s postoperative quality of life.Method The study was retrospective.From January 2012 to December 2019,80 patients who underwent posterior lumbar arthrodesis for lumbar degenerative diseases were included with a mean follow-up of 43.2 months.Mean age was 50.8 years(SD=12.2).Preoperative and postoperative patients'symptoms were assessed by the visual analog scale(VAS),Oswestry Disability Index(ODI),and 12-item Short Form(SF-12).Pre-and post-operative radiographic evaluation included lumbar lordosis measured(LLm),pelvic incidence(PI),sacral slope(SS),and pelvic stilt(PS).Theoretical lumbar lordosis(LLt)was defined by the following:LL=0.54×PI+27.6.Data analysis was done using the statistical software"R."The risk of error was 5%(p<0.05).Result The mean pelvic incidence was 57.23°.There was no statistically significant difference between preoperative and postoperative lumbar lordosis(p=0.2567).There was no statistical difference between preoperative and post-operative PI-LL(p=0.179).There was a statistically significant difference between the pre and postoperative clinical scores(p<0.001).Statistical analysis showed a correlation between recovery of lumbar lordosis and improvement in physical component of SF-12(PCS)(p<0.05)and lumbar and radicular VAS(p<0.05)for the subgroup of narrow lumbar spine.There was a statistical relationship between the restoration of lumbar lordosis and improvement in PCS(p=0.004)and VAS(p=0.003)for the subgroup of isthmic lysis spondylolisthesis.Discussion The root decompression performed in most patients could explain the clinical improvement regardless of recovery of lordosis.The failure to consid

关键词： Posterior lumbar arthrodesis Sagittal alignment Lumbar lordosis Clinical outcomes

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