Does change in focal lordosis after spinal fusion affect clinical outcomes in degenerative spondylolisthesis?
Publication/Presentation Date
1-1-2022
Abstract
STUDY DESIGN: Retrospective cohort study.
OBJECTIVE: The objective of this study is to determine the effect of focal lordosis and global alignment and proportion (GAP) scores on patient reported outcome measures (PROMs) after posterior lumbar fusion for patients with 1- or 2-level lumbar degenerative spondylolisthesis (DS).
SUMMARY OF BACKGROUND DATA: In patients with DS, improvements in spinopelvic parameters are believed to improve clinical outcomes. However, the effect of changing focal lordosis in patients with 1-or 2-level degenerative lumbar spondylolisthesis is unclear.
MATERIALS AND METHODS: Postoperative spinopelvic parameters and perioperative focal lordosis changes were measured for 162 patients at a single academic center from January 2013 to December 2017. Patients were divided into three groups: >2° (lordotic group), between 2° and -2° (neutral group), and -2°° (kyphotic group). Patients were then reclassified based on GAP scores. Recovery ratios (RR) and the number of patients achieving the minimal clinically important difference (MCID) were calculated for PROMs. Standard descriptive statistics were reported for patient demographics and outcomes data. Multiple linear regression analysis controlled for confounders. Alpha was set at
RESULTS: There was no significant association between change in focal lordosis and surgical complications including adjacent segment disease (
CONCLUSIONS: The change in focal lordosis not a significant predictor of change in PROMs for disability, pain, or physical function. Proportioned patients based on the GAP score had worse MCID for Oswestry Disability Index.
LEVEL OF EVIDENCE: III.
Volume
13
Issue
2
First Page
127
Last Page
139
ISSN
0974-8237
Published In/Presented At
Karamian, B. A., DiMaria, S., Lambrechts, M. J., D'Antonio, N. D., Sawires, A., Canseco, J. A., Kaye, I. D., Woods, B. I., Kurd, M. F., Rihn, J. A., Lee, J. K., Hilibrand, A. S., Kepler, C. K., Vaccaro, A. R., & Schroeder, G. D. (2022). Does change in focal lordosis after spinal fusion affect clinical outcomes in degenerative spondylolisthesis?. Journal of craniovertebral junction & spine, 13(2), 127–139. https://doi.org/10.4103/jcvjs.jcvjs_144_21
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
35837437
Department(s)
Administration and Leadership
Document Type
Article