Skip to main content
main-content

28.05.2018 | Review | Ausgabe 8/2018

European Spine Journal 8/2018

Relationship between sagittal balance and adjacent segment disease in surgical treatment of degenerative lumbar spine disease: meta-analysis and implications for choice of fusion technique

Zeitschrift:
European Spine Journal > Ausgabe 8/2018
Autoren:
Kevin Phan, Alexander Nazareth, Awais K. Hussain, Adam A. Dmytriw, Mithun Nambiar, Damian Nguyen, Jack Kerferd, Steven Phan, Chet Sutterlin III, Samuel K. Cho, Ralph J. Mobbs
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-018-5629-6) contains supplementary material, which is available to authorized users.

Abstract

Study design

Meta-analysis.

Objective

To conduct a meta-analysis investigating the relationship between spinopelvic alignment parameters and development of adjacent level disease (ALD) following lumbar fusion for degenerative disease.

Summary of background data

ALD is a degenerative pathology that develops at mobile segments above or below fused spinal segments. Patient outcomes are worse, and the likelihood of requiring revision surgery is higher in ALD compared to patients without ALD. Spinopelvic sagittal alignment has been found to have a significant effect on outcomes post-fusion; however, studies investigating the relationship between spinopelvic sagittal alignment parameters and ALD in degenerative lumbar disease are limited.

Methods

Six e-databases were searched. Predefined endpoints were extracted and meta-analyzed from the identified studies.

Results

There was a significantly larger pre-operative PT in the ALD cohort versus control (WMD 3.99, CI 1.97–6.00, p = 0.0001), a smaller pre-operative SS (WMD − 2.74; CI − 5.14 to 0.34, p = 0.03), and a smaller pre-operative LL (WMD − 4.76; CI − 7.66 to 1.86, p = 0.001). There was a significantly larger pre-operative PI-LL in the ALD cohort (WMD 8.74; CI 3.12–14.37, p = 0.002). There was a significantly larger postoperative PI in the ALD cohort (WMD 2.08; CI 0.26–3.90, p = 0.03) and a larger postoperative PT (WMD 5.23; CI 3.18–7.27, p < 0.00001).

Conclusion

The sagittal parameters: PT, SS, PI-LL, and LL may predict development of ALD in patients’ post-lumbar fusion for degenerative disease. Decision-making aimed at correcting these parameters may decrease risk of developing ALD in this cohort.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Bis zum 22.10. bestellen und 100 € sparen!

Weitere Produktempfehlungen anzeigen
Zusatzmaterial
Supplementary material 1 (PPTX 205 kb)
586_2018_5629_MOESM1_ESM.pptx
Supplementary material 2 (DOCX 36 kb)
586_2018_5629_MOESM2_ESM.docx
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 8/2018

European Spine Journal 8/2018Zur Ausgabe
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

 

 

 
 

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise