• World Neurosurg · Jan 2018

    Effect of single-level transforaminal lumbar interbody fusion on segmental and overall lumbar lordosis in patients with lumbar degenerative disease.

    • Xiaofei Cheng, Feng Zhang, Kai Zhang, Xiaojiang Sun, Changqing Zhao, Hua Li, Yan Michael Li, and Jie Zhao.
    • Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
    • World Neurosurg. 2018 Jan 1; 109: e244-e251.

    ObjectiveTo investigate the ability of transforaminal lumbar interbody fusion (TLIF) to improve lumbar lordosis (LL).MethodsIn this retrospective study, 92 patients undergoing single-level TLIF to treat lumbar degenerative disease were divided into a low back pain, radiculopathy, and neurogenic claudication group according to their symptoms. Preoperative and postoperative measures, including segmental LL, whole LL, pelvic incidence (PI), pelvic tilt, thoracic kyphosis, sagittal vertical axis, visual analog scale for back and leg pain, and Oswestry Disability Index, were used to evaluate radiographic and clinical outcomes.ResultsAll clinical parameters were significantly improved after TLIF. There was no significant difference in any radiographic parameters in the low back pain group. In the radiculopathy and neurogenic claudication groups, all radiographic parameters were significantly changed after TLIF except for segmental LL and PI in both groups and pelvic tilt in the radiculopathy group. No statistically significant differences were found in improvement of segmental LL, PI, thoracic kyphosis, and visual analog scale (leg) between the radiculopathy and neurogenic claudication groups, whereas the differences in improvement of whole LL, pelvic tilt, PI-LL, sagittal vertical axis, visual analog scale (back), and Oswestry Disability Index were significant between the 2 groups.ConclusionsFor patients with neurogenic leg symptoms owing to single-level lumbar degenerative disease, whole LL was improved after TLIF as a result of spontaneous restoration of lordosis at the unfused lumbar levels.Copyright © 2017 Elsevier Inc. All rights reserved.

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