Clin Orthop Surg.  2009 Dec;1(4):207-213. 10.4055/cios.2009.1.4.207.

Radiographic Results of Single Level Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spine Disease: Focusing on Changes of Segmental Lordosis in Fusion Segment

• Kim SB
• Jeon TS
• Heo YM
• Lee WS
• Yi JW
• Kim TK
• Hwang CM

• KMID: 999403
• DOI: http://doi.org/10.4055/cios.2009.1.4.207

Abstract

BACKGROUND
To assess the radiographic results in patients who underwent transforaminal lumbar interbody fusion (TLIF), particularly the changes in segmental lordosis in the fusion segment, whole lumbar lordosis and disc height.
METHODS
Twenty six cases of single-level TLIF in degenerative lumbar diseases were analyzed. The changes in segmental lordosis, whole lumbar lordosis, and disc height were evaluated before surgery, after surgery and at the final follow-up.
RESULTS
The segmental lordosis increased significantly after surgery but decreased at the final follow-up. Compared to the preoperative values, the segmental lordosis did not change significantly at the final follow-up. Whole lumbar lordosis at the final follow-up was significantly higher than the preoperative values. The disc height was significantly higher in after surgery than before surgery (p = 0.000) and the disc height alter surgery and at the final follow-up was similar.
CONCLUSIONS
When performing TLIF, careful surgical techniques and attention are needed to restore and maintain the segmental lordosis at the fusion level.

Keyword

Lumbar osteoarthritis; Spinal fusion; Transforaminal lumbar interbody fusion; Segmental lordosis

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Humans
Intervertebral Disk Degeneration/*surgery
Lordosis/*radiography
Lumbar Vertebrae/pathology/*radiography/surgery
Male
Middle Aged
Prosthesis Implantation
Retrospective Studies
*Spinal Fusion
Spinal Stenosis/surgery
Spondylolisthesis/surgery

Figure

• 

  Fig. 1 The gross morphology of the cage inserted in the procedure.

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  Fig. 2 Cobb's angle for segmental lordosis and whole lumbar lordosis. (A) The segmental lordosis (SL) at L4-5 (a) was defined as the angle subtended by the superior endplate line of L4 and the inferior endplate line of L5. The SL at L5-S1 (b) was defined as the angle subtended by the superior endplate line of L5 and superior endplate line of S1. (B) The whole lumbar lordosis (c) was defined as the angle subtended by the superior endplate line of L1 and superior endplate line of S1.

• 

  Fig. 3 Correlation between both the segmental lordosis and disc height (A) and segmental lordosis and whole lumbar lordosis (B) after surgery. The graph shows a positive correlation between the segmental lordosis and disc height after surgery. However, there was no correlation between the segmental lordosis and whole lumbar lordosis after surgery.

• 

  Fig. 4 Correlation between both segmental lordosis and disc height (A) and segmental lordosis and whole lumbar lordosis (B) after the final follow-up. The graph shows a positive correlation between the segmental lordosis and disc height after the last follow-up. However, there was no correlation between the segmental lordosis and whole lumbar lordosis after the last follow up.

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