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Supine and Dynamic Extension Radiographs as the Strongest Predictors of Post-operative Alignment in Minimally Invasive Lumbar Spine Surgery
STUDY DESIGN: Institutional review board-approved retrospective cohort study. OBJECTIVES: Failure to achieve alignment goals may result in accelerated adjacent segment degeneration and poorer outcomes. In “open” spine surgery, intraoperative tools can fine tune alignment; minimally invasive spine su...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538306/ https://www.ncbi.nlm.nih.gov/pubmed/35192407 http://dx.doi.org/10.1177/21925682221079601 |
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author | Barber, Lauren A. Lafage, Renaud Muzammil, Hamna Shinn, Daniel J. Kim, Jeong H. Lafage, Virginie Iyer, Sravisht |
author_facet | Barber, Lauren A. Lafage, Renaud Muzammil, Hamna Shinn, Daniel J. Kim, Jeong H. Lafage, Virginie Iyer, Sravisht |
author_sort | Barber, Lauren A. |
collection | PubMed |
description | STUDY DESIGN: Institutional review board-approved retrospective cohort study. OBJECTIVES: Failure to achieve alignment goals may result in accelerated adjacent segment degeneration and poorer outcomes. In “open” spine surgery, intraoperative tools can fine tune alignment; minimally invasive spine surgery techniques may not allow for this type of intraoperative adjustment. The aim of this study was to identify pre-operative radiographic parameters that accurately predict post-operative alignment after minimally invasive lumbar spine surgery. We hypothesized that pre-operative supine and extension sagittal alignment would predict post-operative standing alignment. METHODS: 50 consecutive patients underwent lateral or anterior lumbar interbody fusion with or without percutaneous posterior instrumentation by a single-surgeon. Sagittal alignment parameters were evaluated on pre-operative standing scoliosis radiographs, dynamic radiographs, supine CT scout, and 6-week post-operative standing radiographs. Demographic and perioperative data were analyzed. RESULTS: The mean age was 67.8 years. The mean BMI was 29.7. On average, 3 levels were instrumented (range, 2–6). Surgical time was 4.5 ± 1.8 hours. Following surgery, global lordosis increased from 44.7 ± 17° to 48.6 ± 16° (P = .001). However, there was no significant difference between the pre-operative supine (48.5 ± 15°), pre-operative extension (49.2 ± 18°), or 6-week post-operative standing radiographs (48.6 ± 16°). There were strong correlations between post-operative alignment and pre-operative supine (r = .825) and extension (r = .851) alignment. CONCLUSIONS: Our results suggest that pre-operative supine and extension radiographs could be a gold standard for minimally invasive lumbar spine surgery alignment correction as they predict post-operative alignment. The extension alignment was the strongest predictor of post-operative alignment. |
format | Online Article Text |
id | pubmed-10538306 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-105383062023-09-29 Supine and Dynamic Extension Radiographs as the Strongest Predictors of Post-operative Alignment in Minimally Invasive Lumbar Spine Surgery Barber, Lauren A. Lafage, Renaud Muzammil, Hamna Shinn, Daniel J. Kim, Jeong H. Lafage, Virginie Iyer, Sravisht Global Spine J Original Articles STUDY DESIGN: Institutional review board-approved retrospective cohort study. OBJECTIVES: Failure to achieve alignment goals may result in accelerated adjacent segment degeneration and poorer outcomes. In “open” spine surgery, intraoperative tools can fine tune alignment; minimally invasive spine surgery techniques may not allow for this type of intraoperative adjustment. The aim of this study was to identify pre-operative radiographic parameters that accurately predict post-operative alignment after minimally invasive lumbar spine surgery. We hypothesized that pre-operative supine and extension sagittal alignment would predict post-operative standing alignment. METHODS: 50 consecutive patients underwent lateral or anterior lumbar interbody fusion with or without percutaneous posterior instrumentation by a single-surgeon. Sagittal alignment parameters were evaluated on pre-operative standing scoliosis radiographs, dynamic radiographs, supine CT scout, and 6-week post-operative standing radiographs. Demographic and perioperative data were analyzed. RESULTS: The mean age was 67.8 years. The mean BMI was 29.7. On average, 3 levels were instrumented (range, 2–6). Surgical time was 4.5 ± 1.8 hours. Following surgery, global lordosis increased from 44.7 ± 17° to 48.6 ± 16° (P = .001). However, there was no significant difference between the pre-operative supine (48.5 ± 15°), pre-operative extension (49.2 ± 18°), or 6-week post-operative standing radiographs (48.6 ± 16°). There were strong correlations between post-operative alignment and pre-operative supine (r = .825) and extension (r = .851) alignment. CONCLUSIONS: Our results suggest that pre-operative supine and extension radiographs could be a gold standard for minimally invasive lumbar spine surgery alignment correction as they predict post-operative alignment. The extension alignment was the strongest predictor of post-operative alignment. SAGE Publications 2022-02-22 2023-10 /pmc/articles/PMC10538306/ /pubmed/35192407 http://dx.doi.org/10.1177/21925682221079601 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Barber, Lauren A. Lafage, Renaud Muzammil, Hamna Shinn, Daniel J. Kim, Jeong H. Lafage, Virginie Iyer, Sravisht Supine and Dynamic Extension Radiographs as the Strongest Predictors of Post-operative Alignment in Minimally Invasive Lumbar Spine Surgery |
title | Supine and Dynamic Extension Radiographs as the Strongest Predictors of Post-operative Alignment in Minimally Invasive Lumbar Spine Surgery |
title_full | Supine and Dynamic Extension Radiographs as the Strongest Predictors of Post-operative Alignment in Minimally Invasive Lumbar Spine Surgery |
title_fullStr | Supine and Dynamic Extension Radiographs as the Strongest Predictors of Post-operative Alignment in Minimally Invasive Lumbar Spine Surgery |
title_full_unstemmed | Supine and Dynamic Extension Radiographs as the Strongest Predictors of Post-operative Alignment in Minimally Invasive Lumbar Spine Surgery |
title_short | Supine and Dynamic Extension Radiographs as the Strongest Predictors of Post-operative Alignment in Minimally Invasive Lumbar Spine Surgery |
title_sort | supine and dynamic extension radiographs as the strongest predictors of post-operative alignment in minimally invasive lumbar spine surgery |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538306/ https://www.ncbi.nlm.nih.gov/pubmed/35192407 http://dx.doi.org/10.1177/21925682221079601 |
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