Effect of lumbar pedicle subtraction osteotomy level on lordosis distribution and shape

European spine journal

article

Javier Pizones¹  Lucía Moreno-Manzanaro¹  Francisco Javier Sánchez Perez-Grueso¹  Alba Vila-Casademunt²  Caglar Yilgor³  Louis Boissiere⁴  Ahmet Alanay³  Frank Kleinstück³  Emre R. Acaroglu⁵  Ferran Pellisé⁶  Ibrahim Obeid⁴ 

[1] Spine Unit, Department of Orthopedic Surgery, Hospital Universitario La Paz;Spine Research Unit, Vall d’Hebron Institute of Research;Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University;Spine Surgery Unit, Pellegrin University Hospital;Orthopedic Spine Unit, Ankara Spine Center;Spine Surgery Unit, Hospital Universitario Vall d’Hebron

关键词: Pedicle subtraction osteotomy;    Lumbar osteotomy;    Adult spinal deformity;    Roussouly classifcation;    Lordosis distribution;    Adult deformity surgery;   

DOI  :  10.1007/s00586-020-06421-8

来源: Springer

【 摘 要 】

Little is known about the qualitative results (postoperative upper/lower lumbar arches distribution and lumbar apex or inflection point positioning) of lumbar pedicle subtraction osteotomies (L-PSO) depending on the level of L-PSO. We conducted a retrospective analysis of prospectively collected data of adult deformity patients undergoing single-level L-PSO. We analyzed several variables in preoperative and postoperative sagittal radiographs: L-PSO level, Roussouly classification (R-type), inflection point (InfP), lumbar apex (LApex), spinopelvic parameters, lordosis distribution index (LDI = L4–S1/L1–S1), and number of levels in the lordosis (NVL). Comparisons between PSO levels were performed to determine lordosis distribution and sagittal shape using ANOVA test and Chi-squared statistics. A total of 126 patients were included in this study. L5-PSO mainly increased the lower lumbar arch, thereby increasing LDI. L4 increased upper/lower arches similarly. PSOs at and above L3 increased the upper lumbar arch, thereby decreasing LDI (P  0.05. The level of L-PSO influenced upper/lower lumbar arches distribution, and lumbar apex and inflection point positioning. The correct level should be chosen based on the individual assessment of each patient.

【 授权许可】

Unknown