Preoperative lordosis in L4/5 predicts segmental lordosis correction achievable by transforaminal lumbar interbody fusion
Clara Berlin, Ferdinand Zang, Henry Halm, Markus Quante
May 2021, Volume 30, Issue 5, pp 1277 - 1284 Original Article Read Full Article 10.1007/s00586-020-06710-2
First Online: 06 January 2021
The mean potential of lordosis restoration by transforaminal lumbar interbody fusion (TLIF) is supposed to be low in general. In contrast, clinical experience shows a wide range of segmental lordosis correction. In this study, the predictability of lordosis correction should be investigated.
Prospectively collected register data were analyzed retrospectively. One hundred twenty-one consecutive patients (2014–2016) operated with single-level TLIF L4/5 (10°-lordotic cage). Segmental lordosis (L4/5) and overall lordosis (L1–S1) were measured on lumbar X-rays: preoperatively (pre), after 3–5 days (post), at least 24 months postoperatively (2yFU). Outcome and satisfaction of patients were assessed. Parameters were statistically compared by students t-tests (a = 0.05). In addition, predictors of correction were analyzed.
Age was 60.7 years, rate of 2yFU 41.3% (n = 50). Lordosis correction L4/5 was statistically significant with (post–pre) 4.9 ± 5.7° (p
Significant segmental relordosation can be performed by TLIF L4/5. The potential of correction strongly correlates with preoperative lordosis. Therefore, TLIF technique should be considered carefully in cases with a preoperative segmental lordosis of more than 15° and additional need of lordosation.
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