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Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: A CONSORT-compliant article
The effect on degenerative thoracolumbar kyphosis (DTLK) after short-segment instrument for lumbar spinal stenosis syndrome (LSS) remains controversial. Based on the biomechanics and compensatory of the global spino-pelvic alignment, it was assumed that the interference on the lumbar spine, instead...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545290/ https://www.ncbi.nlm.nih.gov/pubmed/34766574 http://dx.doi.org/10.1097/MD.0000000000027711 |
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author | Xu, Shuai Guo, Chen Liang, Yan Zhu, Zhenqi Zhang, Hongguang Liu, Haiying |
author_facet | Xu, Shuai Guo, Chen Liang, Yan Zhu, Zhenqi Zhang, Hongguang Liu, Haiying |
author_sort | Xu, Shuai |
collection | PubMed |
description | The effect on degenerative thoracolumbar kyphosis (DTLK) after short-segment instrument for lumbar spinal stenosis syndrome (LSS) remains controversial. Based on the biomechanics and compensatory of the global spino-pelvic alignment, it was assumed that the interference on the lumbar spine, instead of the thoracolumbar segment, could still make a difference on the proximal spine. To explore whether DTLK could improve with only surgery for LSS and identify influencing factors on postoperative TLK. The study was performed from January 2016 to December 2018. Sixty-nine participants (25 male) diagnosed LSS with DTLK were enrolled and surgery was only for LSS. Radiological parameters included TLK, lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, and osteoporosis. Clinical outcomes were visual analogue scale and Oswestry disability index. According to lower instrumented vertebrae (LIV) on L5 or S1, inter-group comparisons were performed between LIV on L5 (L5 group) and S1 (S1 group). Demographics were well-matched between L5 and S1 group with a mean follow-up of 24.3 ± 12.1 (m). TLK improved with a mean of 16.2 ± 7.6 (°) (P < .001). There was no significance on radiological and clinical parameters between L5 and S1 groups except for a larger pelvic tilt in S1 group (P = .046). Visual analogue scale (P = .787) and Oswestry disability index (P = .530) were both indifferent between normal TLK and DTLK at last (P > .05). Postoperative TLK was affected by osteoporosis and sacral slope, the latter was dominated by pelvic incidence and pelvic rotation. Osteoporosis was the risk factor for TLK correction (P = .001, odd risk = 9.58). DTLK decreased if instrument only performed for LSS, where TLK and clinical outcomes are comparably affected whether L5 or S1 is selected as LIV. This study supplements the compensatory mechanism of spino-pelvic alignment, especially for cases with severe osteoporosis. |
format | Online Article Text |
id | pubmed-10545290 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-105452902023-10-03 Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: A CONSORT-compliant article Xu, Shuai Guo, Chen Liang, Yan Zhu, Zhenqi Zhang, Hongguang Liu, Haiying Medicine (Baltimore) 7100 The effect on degenerative thoracolumbar kyphosis (DTLK) after short-segment instrument for lumbar spinal stenosis syndrome (LSS) remains controversial. Based on the biomechanics and compensatory of the global spino-pelvic alignment, it was assumed that the interference on the lumbar spine, instead of the thoracolumbar segment, could still make a difference on the proximal spine. To explore whether DTLK could improve with only surgery for LSS and identify influencing factors on postoperative TLK. The study was performed from January 2016 to December 2018. Sixty-nine participants (25 male) diagnosed LSS with DTLK were enrolled and surgery was only for LSS. Radiological parameters included TLK, lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, and osteoporosis. Clinical outcomes were visual analogue scale and Oswestry disability index. According to lower instrumented vertebrae (LIV) on L5 or S1, inter-group comparisons were performed between LIV on L5 (L5 group) and S1 (S1 group). Demographics were well-matched between L5 and S1 group with a mean follow-up of 24.3 ± 12.1 (m). TLK improved with a mean of 16.2 ± 7.6 (°) (P < .001). There was no significance on radiological and clinical parameters between L5 and S1 groups except for a larger pelvic tilt in S1 group (P = .046). Visual analogue scale (P = .787) and Oswestry disability index (P = .530) were both indifferent between normal TLK and DTLK at last (P > .05). Postoperative TLK was affected by osteoporosis and sacral slope, the latter was dominated by pelvic incidence and pelvic rotation. Osteoporosis was the risk factor for TLK correction (P = .001, odd risk = 9.58). DTLK decreased if instrument only performed for LSS, where TLK and clinical outcomes are comparably affected whether L5 or S1 is selected as LIV. This study supplements the compensatory mechanism of spino-pelvic alignment, especially for cases with severe osteoporosis. Lippincott Williams & Wilkins 2021-11-12 /pmc/articles/PMC10545290/ /pubmed/34766574 http://dx.doi.org/10.1097/MD.0000000000027711 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | 7100 Xu, Shuai Guo, Chen Liang, Yan Zhu, Zhenqi Zhang, Hongguang Liu, Haiying Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: A CONSORT-compliant article |
title | Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: A CONSORT-compliant article |
title_full | Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: A CONSORT-compliant article |
title_fullStr | Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: A CONSORT-compliant article |
title_full_unstemmed | Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: A CONSORT-compliant article |
title_short | Posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: A CONSORT-compliant article |
title_sort | posterior instrumented fusion on lumbar stenosis syndrome can bring benefit to proximal degenerative kyphosis: a consort-compliant article |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545290/ https://www.ncbi.nlm.nih.gov/pubmed/34766574 http://dx.doi.org/10.1097/MD.0000000000027711 |
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