Is Age-adjusted Sagittal Parameter Important for Patients Receiving Short Anterior and Oblique Anterolateral Lumbar Surgery?
Background: Recent studies have suggested the sagittal profiles: sagittal vertical axis (SVA), pelvic tilt (PT), and pelvic incidence minus lumbar lordosis (PI-LL) may be age dependent. However, the clinical applications of the age-adjusted parameters remain inconclusive. Objectives: This study aims...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Formosan Journal of Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/FJMD.FJMD_311 |
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| Summary: | Background:
Recent studies have suggested the sagittal profiles: sagittal vertical axis (SVA), pelvic tilt (PT), and pelvic incidence minus lumbar lordosis (PI-LL) may be age dependent. However, the clinical applications of the age-adjusted parameters remain inconclusive.
Objectives:
This study aims to investigate whether age-adjusted sagittal parameter is important for patients receiving short anterolateral lumbar surgery since the recently increased adoption of this surgery.
Materials and Methods:
Patients receiving anterior lumbar interbody fusion (ALIF) and oblique lumbar interbody fusion (OLIF) for degenerative spine disease were prospectively collected. The severity of symptoms was measured via the health-related quality of life (HRQOL) score. After the operation, patients were divided into either the “sufficient group” or “under group” in accordance with whether they achieved the three age-adjusted parameters. Postoperative clinical outcomes were measured and compared with baselines before operative (OP) between the groups at 2-year follow-up. In addition, patients were stratified through the severity cutoff value of each HRQOL score before surgery for subgroup analysis.
Results:
All age-adjusted parameters and HRQOL showed a significant improvement after receiving ALIF or OLIF. The sufficient correction rate was 78%, 74%, and 70% in age-adjusted SVA, PT, and PI-LL, respectively. The European Quality of Life in 5-Dimensional Scale (EQ-5D), Oswestry Disability Index (ODI), and Visual Analog Scale of Pain (VASP)-Total demonstrated significant improvements at 2-year follow-up upon all patients. Sufficient correction of age-adjusted SVA, PT, and PI-LL revealed better performance in EQ-5D, ODI, and VASP-Total and VASP-Back among patients with worse pre-OP disability. However, no difference in HRQOL was observed despite SVA, PT, and PI-LL being sufficiently corrected among patients with moderate disability. ALIF and OLIF shared similar outcomes in sagittal alignments and HRQOLs.
Conclusions:
Both ALIF and OLIF could achieve satisfactory clinical results targeting age-adjusted thresholds for patients with symptomatic degenerative lumbar disorders, including SVA, PT, and PI-LL. Among those patients with a worse disability before surgery, a rigorous sufficient correction may be required in accordance with age-adjusted targets to achieve better HRQOL. Due attention paid to intra-OP manipulation for age-adjusted targets should continue to be studied in the future. |
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| ISSN: | 2210-7940 2210-7959 |