Abstract
Objectives
To analyze the changes in the height of the intervertebral disc, the slippage, slip angle, lumbar lordotic angle and sacral inclination after anterior lumbar interbody fusion and posterior pedicle screw fixation in a lumbar spondylolisthesis.
Summary of Literature Review
The anterior lumbar interbody fusion causes changes in the lumbar sagittal alignment.
Methods
The mini- open anterior lumbar interbody fusion and pedicle screw fixation was undertaken in 33 cases from A pril 1995 to November 2003. MRI was done before and 6 months after surgery. The measuring factors were the heights of the intervertebral disc, slippage, slip angle, lumbar lordotic angle and sacral inclination. The measuring factors were independently assessed three times by three different orthopedic surgeons. The postoperative changes in measuring the factors were analyzed by a paired t- test statistically.
Results
The height of the intervertebral disc was increased by a mean of 14.0%, slippage was reduced by a mean of 2.8%, the slip angle was reduced by a mean of 16.0%, the lumbar lordotic angle was increased by a mean of 15.6% and the scaral inclination was increased by a mean of 3.0%. There was significance in the increase in the disc height, the reduction of slippage and the slip angle, and the increase in lumbar lordotic angle, but there were no significance regarding the changes in sacral inclination.
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Figures and Tables%
Table 1.
Isthmic type | Degenerative type | |
---|---|---|
Number of cases | 16 | 17 |
Mean Age (years) | 50 | 61 |
Gender (M:F) | 3 : 13 | 3 : 14 |
Slip level | ||
L3 | 1 | 4 |
L4 | 10 | 11 |
L5 | 5 | 2 |
Meyerding grade | ||
I | 14 | 15 |
II | 2 | 2 |
Taillard (%) | 11.96 | 8.78 |
Followup of MRI* (months) | 27.1 | 21.4 |
Radiologic union (months) | 5.4 | 6.2 |
Table 2.
preop | postop | p-value | |
---|---|---|---|
disc height rate (%) | 19.6 | 33.6 | 0.000 |
slip (Taillard %) | 10.3 | 7.6 | 0.000 |
slip angle (°) | 6.5 | 5.6 | 0.012 |
lumar lordosis (°) | 31.4 | 37.2 | 0.015 |
sacral inclination (°) | 41.9 | 42.9 | 0.341 |
Table 3.
disc height restoration (postop disc height rate-preop disc height rate) |
14.0% |
slip reduction preop % slip-postop % slip) |
2.8% |
slip angle correction rate ((postop SA*-preop SA*)/postop SA*100) |
16.0% |
lumar lordosis change ((postop LA**-preop LA**)/postop LA*100) |
15.6% |
sacral inclination change ((postop SI‡ -preop SI‡)/postop SI*100) |
3.0% |