Failures of lumbosacral instrumented fusions addressing degenerative lumbar disease

BACKGROUND: Here, we evaluated the failure to preserve or restore adequate spinopelvic alignment following lumbosacral instrumented fusions for degenerative disease. METHODS: Patients undergoing lumbosacral instrumented fusions for degenerative spine disease underwent; standing lumbopelvic X-rays and lumbar MRI scans obtained both preoperatively and 1 year postoperatively. Parameters measured included lumbar lordosis (LL), L4-S1 angle, pelvic incidence (PI), and LL-PI mismatch. RESULTS: Fifty patients were followed for 1 year following lumbopelvic fusion. There was a statistically significant difference in the L4-S1 angle between patients with good versus poor clinical outcomes at 1 year postoperative; the LL-PI mismatch showed a strong positive correlation with better outcome scores. CONCLUSION: Preservation of an adequate LL/other lumbosacral parameters favorably impacts patients’ outcomes following lumbosacral fusion for degenerative disease.