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Lumbar Lordosis Restoration Following Single-level Instrumented Fusion Comparing 4 Commonly Used Techniques.
MedLine Citation:
PMID:  22049959     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
A major sequelae of lumbar fusion is acceleration of adjacent-level degeneration due to decreased lumbar lordosis. We evaluated the effectiveness of 4 common fusion techniques in restoring lordosis: instrumented posterolateral fusion, translumbar interbody fusion, anteroposterior fusion with posterior instrumentation, and anterior interbody fusion with lordotic threaded (LT) cages (Medtronic Sofamor Danek, Memphis, Tennessee). Radiographs were measured preoperatively, immediately postoperatively, and a minimum of 6 months postoperatively. Parameters measured included anterior and posterior disk space height, lumbar lordosis from L3 to S1, and surgical level lordosis.No significant difference in demographics existed among the 4 groups. All preoperative parameters were similar among the 4 groups. Lumbar lordosis at final follow-up showed no difference between the anteroposterior fusion with posterior instrumentation, translumbar interbody fusion, and LT cage groups, although the posterolateral fusion group showed a significant loss of lordosis (-10°) (P<.001). Immediately postoperatively and at follow-up, the LT cage group had a significantly greater amount of lordosis and showed maintenance of anterior and posterior disk space height postoperatively compared with the other groups. Instrumented posterolateral fusion produces a greater loss of lordosis compared with anteroposterior fusion with posterior instrumentation, translumbar interbody fusion, and LT cages. Maintenance of lordosis and anterior and posterior disk space height is significantly better with anterior interbody fusion with LT cages.
Authors:
John R Dimar; Steven D Glassman; Venu M Vemuri; Justin L Esterberg; Jennifer M Howard; Leah Y Carreon
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Publication Detail:
Type:  Journal Article     Date:  2011-11-09
Journal Detail:
Title:  Orthopedics     Volume:  34     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e760-4     Citation Subset:  IM    
Copyright Information:
Copyright 2011, SLACK Incorporated.
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