Abstract
To evaluate the clinical significance of spinal decompression and fusion for lumbar spinal stenosis in old patients under Roussouly classification, 160 old patients (>60 year old) with lumbar spinal stenosis underwent spinal decompression, and fusion were retrospectively studied. According to Roussouly classification, patients were divided into 4 groups, in which Roussouly types I, II, and IV were the nonstandard group and Roussouly type III was the standard group. Visual analog scale (waist, leg) and Oswestry disability index (ODI) scores were recorded before operation and at the final follow-up. All patients improved the sagittal curvature: for patients in Roussouly types I and II, there were statistically significant differences in terms of postoperative global lordosis (GL), global kyphosis (GK), sacral slope (SS), sagittal vertical axis (SVA), and pelvic tilt (PT) compared with that before surgery (all P < 0.001); patients in Roussouly type IV obtained similar results with type III after surgery. The four groups showed significant improvement in ODI and VAS scores at final follow-up (all P < 0.001). After regrouping at the final follow-up, the proportion of the standard type (Roussouly type III) patients was increased compared with preoperative. In conclusion, Roussouly classification has important guiding significance in spinal decompression and fusion for old patients (>60 years) with lumbar spinal stenosis.
Highlights
The spine-pelvis plays an important role in maintaining the upright posture of the human body [1, 2]
The patients were divided into 4 groups with Roussouly classification, and intergroup comparisons of preoperative or postoperative factors revealed that there was no significant difference among groups including age, gender, BMI, duration of symptom, number of fusion segments, operative time, blood loss, length of hospital stay, or follow-up time
All the results showed that the improvement of lumbar curvature in patients, especially patients in Roussouly type I, Roussouly type II, and Roussouly type IV
Summary
The spine-pelvis plays an important role in maintaining the upright posture of the human body [1, 2]. The spino-pelvic sagittal balance allows the body to maintain an upright posture with minimal energy consumption, while cushioning the impact and shock of movement on the spinal cord [3, 4]. Human beings have adjacent physiological curvature, including cervical kyphosis, thoracic kyphosis, lumbar kyphosis, and sacral kyphosis. In this spine-pelvis-hinged structure, adjacent kyphosis and kyphosis segments are closely related to each other. Lumbar lordosis plays a bridging role between the pelvis and the thoracic curvature in the sagittal sequence and is the core of the adjustment of sagittal spino-pelvic and balance [5]. Numerous studies have reported that restoring and maintaining the spino-pelvic sagittal balance in the treatment of degenerative diseases of the
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