Abstract
ABSTRACT Objective: To evaluate the influence of the MIS-TLIF technique on the spinopelvic parameters of patients submitted to lumbar arthrodesis up to three levels for the treatment of vertebral degenerative conditions without deformity. Methods: Retrospective radiographic evaluation of 52 patients submitted to the surgical treatment of lumbar arthrodesis using the MIS-TLIF technique in up to three levels. The spinopelvic parameters – pelvic incidence (PI), pelvic tilt(PT), lumbar lordosis (LL), segmental lordosis (Lseg), and the difference between lumbar lordosis and pelvic incidence (LL-PI mismatch) were analyzed in orthostatic lateral radiographs in the pre- and postoperative periods, with a minimum follow-up of 1 year. The patients were divided into three groups: PI <45°, PI between 45° and 55° and PI >55°. Results: Sixty-nine operated levels were evaluated in 15 patients with PI <45°, 19 with PI between 45° and 55° and 18 with PI >55°. The mean value of the pelvic incidence was 52.3° (± 11.5), lumbar lordosis 46.1° (pre)/45.6° (post); segmental lordosis 20.3° (pre)/20.6° (post); pelvic tilt 18.5° (pre)/18.2° (post); “mismatch” (PI-LL) 7° (pre)/ 6.6° (post), with no statistical difference among all parameters (p>0.05). Conclusions: The MIS-TLIF technique had no influence on postoperative spinopelvic parameters of patients undergoing lumbar arthrodesis surgery. Level of evidence: III. Retrospective comparative study.
Highlights
The loss of lordosis and consequent change in the spinopelvic parameters are common in degenerative conditions that affect the lumbar spine.[1,2,3,4] Their analysis becomes highly important when considering surgical intervention, especially in terms of arthrodesis planning
The MIS-TLIF technique had no influence on postoperative spinopelvic parameters of patients undergoing lumbar arthrodesis surgery
The objective of this study is to evaluate the impact of the standard MIS-TLIF technique on the radiographic spinopelvic parameters of patients with degenerative conditions as the therapeutic indication and who underwent surgical treatment for degenerative conditions of the lumbar spine at up to three levels
Summary
The loss of lordosis and consequent change in the spinopelvic parameters are common in degenerative conditions that affect the lumbar spine.[1,2,3,4] Their analysis becomes highly important when considering surgical intervention, especially in terms of arthrodesis planning. The restoration of these parameters is related to better clinical and radiological results, with higher rates of fusion and a decrease in the incidence of adjacent level disease.[5]. As compared to the traditional technique, less intraoperative bleeding, a shortened hospital stay, and early postoperative recovery stand out, in addition to interesting and compelling cost-effectiveness indices.[8,9] Despite this, there are controversies in the literature around the ability of this technique to maintain and/ or increase segmental lordosis, exercising potential influence on the final spinopelvic parameters and affecting the clinical outcome.[5]
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