• Han Soo Chang.
• Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan. Electronic address: chang-ind@umin.ac.jp.
• World Neurosurg. 2018 Jan 1; 109: e684-e690.

ObjectiveAlthough sagittal spinal balance plays an important role in spinal deformity surgery, its role in decompression surgery for lumbar canal stenosis is not well understood. To investigate the hypothesis that sagittal spinal balance also plays a role in decompression surgery for lumbar canal stenosis, a prospective cohort study analyzing the correlation between preoperative lumbar lordosis and outcome was performed.MethodsA cohort of 85 consecutive patients who underwent decompression for lumbar canal stenosis during the period 2007-2011 was analyzed. Standing lumbar x-rays and 36-item short form health survey questionnaires were obtained before and up to 2 years after surgery. Correlations between lumbar lordosis and 2 parameters of the 36-item short form health survey (average physical score and bodily pain score) were statistically analyzed using linear mixed effects models.ResultsThere was a significant correlation between preoperative lumbar lordosis and the 2 outcome parameters at postoperative, 6-month, 1-year, and 2-year time points. A 10° increase of lumbar lordosis was associated with a 5-point improvement in average physical scores. This correlation was not present in preoperative scores.ConclusionsThis study showed that preoperative lumbar lordosis significantly influences the outcome of decompression surgery on lumbar canal stenosis.Copyright © 2017 Elsevier Inc. All rights reserved.

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