Relationship Between Alterations of Spinal/Pelvic Sagittal Parameters and Clinical Outcomes After Oblique Lumbar Interbody Fusion

• Published in: World neurosurgery 2020-01, Vol.133, p.e156-e164
• Main Authors: Xiao, Liang, Zhao, Quanlai, Sun, Xiumin, Liu, Chen, Zhang, Yu, Xu, Hongguang
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anthropometry; Clinical outcome; Female; Follow-Up Studies; Humans; Lumbar degenerative disease; Lumbar Vertebrae - surgery; Male; Middle Aged; Oblique lateral interbody fusion; Pelvic Bones - diagnostic imaging; Pelvic Bones - pathology; Retrospective Studies; Spinal Diseases - surgery; Spinal Fusion - methods; Spinal/pelvic sagittal parameter; Spine - diagnostic imaging; Spine - pathology; Treatment Outcome
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2019.08.158

To elucidate the correlation between changes in spinal/pelvic sagittal parameters and clinical treatment outcomes after oblique lumbar interbody fusion (OLIF). Eighty-two patients with lumbar degenerative disease (LDD) treated by OLIF were retrospectively analyzed. The visual analog scale (VAS) score and Oswestry Disability Index (ODI) score were compared before and after surgery. Disk height (DH) and various spinal/pelvic sagittal parameters, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), and sagittal vertical axis (SVA), were measured preoperatively and at the last postoperative follow-up. The correlation between the changes in sagittal parameters before and after surgery and the clinical treatment outcomes were observed. ODI score, VAS score, and DH were significantly better at the last follow-up compared with before surgery. The change in PI was not statistically significant before and after surgery. PT significantly decreased and SS and LL significantly increased after surgery. Significant linear relationships were found for several independent variables (difference in DH before and after surgery, postoperative LL, difference in LL before and after surgery, PI–LL match status, and SVA status) and the dependent variable ODI. The difference in DH before and after surgery showed the strongest correlation. The percentages of PI–LL match were 37% before surgery and 66% after surgery. The percentage of the normal SVA was 9% before surgery and 62% after surgery. OLIF for treatment of LDD had significant clinical outcomes, effectively restored the spinal/pelvic sagittal balance, and helped to improve the patients' clinical conditions.