• Sam Yeol Chang, Yeonho Kim, Junho Kim, Hyoungmin Kim, Ho-Joong Kim, Jin S Yeom, Choon-Ki Lee, and Bong-Soon Chang.
• Department of Orthopaedic Surgery, Seoul National University Hospital, Jongrogu, Seoul, Republic of Korea.
• Spine. 2021 Mar 1; 46 (5): 300-306.

Study DesignRetrospective case-control study.ObjectiveThe aim of this study was to describe and compare the sagittal spinal alignment between patients with and without the ossification of the ligamentum flavum in the thoracic spine (TOLF).Summary Of Background DataAlthough mechanical factors play an important role in the development of TOLF, limited evidence exists on the association of sagittal spinal alignment and TOLF in the literature.MethodsThe present study assessed the preoperative sagittal alignment parameters in consecutive patients who underwent posterior decompression for TOLF in a single institution between January 2014 and December 2019. The sagittal parameters of the patients with TOLF were compared to those of the age- and sex-matched control group with lumbar spondylosis.ResultsThe TOLF group (n = 43 [23 men, 20 women]), with a mean age of 69.5 (range: 41-86) years, and the control group (n = 86) were compared. The TOLF group had a significantly smaller sacral slope (27.60 ± 7.49 vs. 30.61 ± 8.15, P = 0.045) and lumbar lordosis (36.84 ± 13.63 vs. 45.08 ± 9.90, P < 0.001) and a larger pelvic incidence minus lumbar lordosis (PI-LL, 8.06 ± 15.05 vs.1.00 ± 11.34, P = 0.004) than the control group. Moreover, the thoracic kyphosis was smaller in the TOLF group, although the difference was not statistically significant (25.73 ± 11.29 vs. 28.22 ± 9.34, P = 0.187). The TOLF group had a significantly smaller slope angle at the inflection point (11.97 ± 5.85 vs. 15.78 ± 5.62, P < 0.001) and a higher tendency to have a Roussouly type 2 morphology (46.5% vs. 36.0%, P = 0.252) than the control group.ConclusionThis is the first study to describe the sagittal alignment in patients with TOLF. The TOLF group showed a hypolordotic spine with a larger PI-LL mismatch compared to the age- and sex-matched control group with lumbar spondylosis.Level of Evidence: 4.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

25 keywords...

hide…