Restoration of Segmental Lordosis and Related Factors in Interbody Fusion for Degenerative Lumbar Disease (퇴행성 요추 질환에서 추체간 유합술을 통한 분절 전만각 복원 및 관여 인자)

김응하; 서정무; Joong Hyeon Ahn (안중현)

Restoration of Segmental Lordosis and Related Factors in Interbody Fusion for Degenerative Lumbar Disease

Journal of Korean Society of Spine Surgery
Abbr : J Kor Spine Sur
2015, 22(4), pp.170-177
Publisher : Korean Society Of Spine Surgery
Research Area : Medicine and Pharmacy > Orthopedic Surgery

김응하 ¹, 서정무 ¹, Joong Hyeon Ahn ¹

¹순천향대학교

Accredited

ABSTRACT

Study Design: A retrospective study. Objectives: To analyze restoration of segmental lordosis and factors related to interbody fusion and the fusion rate with degenerative lumbar disease. Summary of Literature Review: Few studies have addressed the restoration of segmental lordosis and factors related to interbody fusion for degenerative lumbar disease. Materials and Methods: Records of 43 patients treated by anterior lumbar interbody fusion (ALIF) or posterior lumbar interbody fusion (PLIF) surgery from 2011 to 2013 were reviewed. ALIF used a metal cage with a 10° lordotic angle and PLIF used a metal cage with an 8° lordotic angle. Preoperative, postoperative, and at least 1 year outcomes were analyzed from radiographs. As a related factor, segmental flexibility, disc height, osteophytes, vaccuum disc, hypertrophic facet, spondylolisthesis, and endplate violation were analyzed. We also analyzed the bony union rate. Results: The segmental lordotic angle was 4.67° before surgery, improved to 10.43° after surgery, and was 9.32° at the final follow-up. Comparing between the ALIF and PLIF at the L3-4 level in a similar number of patients revealed 7.24° and 4.61° restoration after ALIF and PLIF surgery, postoperatively. The difference was statistically significant (p=0.011). Segmental flexibility had a statistically significant positive correlation (p=0.013). Lower disc height and osteophytes limited restoration of segmental lordosis, but vaccuum disc was restored well after interbody fusion. Bony union was achieved in 92.8% of the cases. Conclusions: Intebody fusion, especially ALIF surgery, results in acceptable restoration of segmental lordosis. Even with narrowed disc space or osteophytes, remained segmental flexibility is an important factor of segmental lordosis restoration.

KEYWORDS

Degenerative lumbar disease, Interbody fusion, Segmental lordosis, Segmental flexibility, Fusion rate

Citation status

* References for papers published after 2023 are currently being built.

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