Lumbo-sacral transitional vertebrae (LSTV) are frequent congenital variances of the spine and are associated with increased spinal degeneration. Nevertheless, there is a lack of data whether bony alterations associated with LSTV result in reduced segmental restoration of lordosis when performing ALIF. 58 patients with monosegmental stand-alone ALIF in the spinal segment between the 24th and 25th vertebra (L5/S1)/(L5/L6) where included. Of these, 17 patients had LSTV and were matched to a control population by age and sex. Pelvic incidence, pelvic tilt, sagittal vertical axis, lumbar lordosis, segmental lordosis, disc height and depth were compared. LSTV-patients had a significantly reduced segmental lordosis L4/5 (p = 0.028) and L5/S1/(L5/L6) (p = 0.041) preoperatively. ALIF resulted in a significant increase in segmental lordosis L5/S1 (p < 0.001). Postoperatively, the preoperatively reduced segmental lordosis was no longer significantly different in segments L4/5 (p = 0.349) and L5/S1/(L5/6) (p = 0.576). ALIF is associated with a significant increase in segmental lordosis in the treated segment even in patients with LSTV. Therefore, ALIF is a sufficient intervention for restoring the segmental lordosis in these patients as well.
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http://dx.doi.org/10.1038/s41598-024-53179-w | DOI Listing |
J Orthop Surg Res
January 2025
Department of Orthopaedic and Trauma Surgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
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Bioengineering (Basel)
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Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan.
Background: Sagittal alignment in the lumbar spine is essential for spinal stability and functionality, with significant implications in surgical planning for spinal deformity correction. However, standardized lumbar partitioning, particularly identifying a critical sagittal alignment zone, remains underdefined. This study aims to establish a reliable lumbar partition to guide surgical decisions and optimize clinical outcomes.
View Article and Find Full Text PDFNeurospine
December 2024
Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Objective: Uniportal full-endoscopic transforaminal lumbar interbody fusion (FE-TLIF) carries a unique risk of nerve traction and abrasion injury during cage insertion. This study aims to evaluate the clinical efficacy of the GUARD technique and delayed ligamentum flavectomy in reducing postoperative radicular pain and neurapraxia in patients undergoing uniportal FE-TLIF.
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Asian Spine J
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Department of Spine Surgery and Orthopaedics, Xiangya Hospital of Central South University, Changsha, China.
Study Design: A retrospective study.
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N Am Spine Soc J
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Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Background: Previous research on spinal alignment and postoperative outcomes after cervical and upper thoracic fixation has suggested that clinical and patient-reported outcomes are improved when certain anatomical parameters are maintained. These parameters include the cervical sagittal vertical axis (cSVA), C2 and T1 slopes, and cervical lordosis (CL). For patients with primary and metastatic tumors involving the subaxial cervical and/or upper thoracic spine, there is minimal guidance on how to apply these parameters.
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