The Effect of Preoperative Sagittal Malalignment on Clinical Outcomes in Short-Segment Lumbar Interbody Fusion
Yukitoshi Shimamura, Masahiro Kanayama, Fumihiro Oha, Michihaya Kono, Ryo Fujita, Shogo Fukase, Kohei Shiota, Tsutomu Endo, Tomoyuki Hashimoto, Norimasa IwasakiStudy Design
retrospective case-control study.
Objectives
The objective is to investigate how preoperative sagittal malalignment affects clinical outcomes in short-segment lumbar interbody fusion.
Methods
A total of 684 patients who underwent short-segment lumbar interbody fusion were reviewed with a minimum follow-up of 2 years. According to the SRS-Schwab Adult Spinal Deformity Classification, preoperative sagittal malalignment was defined as a sagittal vertical axis (SVA) ≥ 95 mm or pelvic tilt (PT) ≥ 30 degrees or Pelvic incidence (PI) – Lumbar lordosis (LL) ≥ 20 degrees in this study. Patients were divided into a well-alignment group and a malalignment group. Spinopelvic parameters such as thoracic kyphosis (TK), LL, lower LL (LLL), sacral slope (SS), PT, PI, SVA, T1 pelvic angle (TPA), and segmental lordosis (SL), as well as Visual Analog Scale (VAS) of low back pain and leg pain, Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RDQ) were measured preoperatively and at the final follow-up.
Results
The well-alignment group included 443 patients, and the malalignment group included 241 patients. In the malalignment group, PT, PI, SVA
Conclusion
This study demonstrated that preoperative sagittal malalignment and spinopelvic parameters were not associated with clinical outcomes except for the satisfaction rate in short-segment lumbar interbody fusion.