Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging Analysis
Background/Objectives: This study investigated whether decompression surgery for lumbar spinal stenosis can effectively improve sagittal alignment in elderly patients. With the growing focus on sagittal balance in spinal surgery, this study aimed to evaluate post-decompression alignment changes and...
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MDPI AG
2024-10-01
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| author | Hyung-Youl Park Ho-Young Jung Geon-U Kim Se-Heon Lee Jun-Seok Lee |
| author_facet | Hyung-Youl Park Ho-Young Jung Geon-U Kim Se-Heon Lee Jun-Seok Lee |
| author_sort | Hyung-Youl Park |
| collection | DOAJ |
| description | Background/Objectives: This study investigated whether decompression surgery for lumbar spinal stenosis can effectively improve sagittal alignment in elderly patients. With the growing focus on sagittal balance in spinal surgery, this study aimed to evaluate post-decompression alignment changes and identify the factors influencing these changes using the EOS imaging system. Methods: A retrospective analysis was conducted on 49 elderly patients who underwent decompression surgery alone for lumbar spinal stenosis. Radiologic parameters, measured using the EOS system, and clinical outcomes were assessed preoperatively, at two weeks postoperatively, and at one year postoperatively. Patients were grouped based on the improvement of the sagittal vertical axis (SVA) by 25 mm or more. A multivariate analysis was performed to identify factors affecting sagittal alignment changes. Results: Significant sagittal alignment improvements were observed postoperatively, including a notable increase in thoracic kyphosis and a decrease in SVA observed at one year. Clinical outcomes, such as the Oswestry disability index (ODI) and EQ-5D, significantly improved at both two weeks and one year postoperatively compared to preoperative values (all <i>p</i>-values < 0.05). Multivariate analysis revealed that greater preoperative SVA and higher ODI were significant predictors of sagittal alignment changes (odds ratio [OR] for SVA = 1.014, OR for ODI = 1.034). Conclusions: Decompression surgery for lumbar spinal stenosis in elderly patients can result in significant improvements in sagittal alignment and clinical outcomes. The study suggests that decompression alone is a viable surgical option for elderly patients, particularly those with a greater preoperative sagittal imbalance and disability, even in the absence of major deformities. |
| format | Article |
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| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-10-01 |
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| spelling | doaj-art-4d0e83e9e4f7496098d4a0a90abbbd7f2025-08-20T02:13:16ZengMDPI AGDiagnostics2075-44182024-10-011421238010.3390/diagnostics14212380Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging AnalysisHyung-Youl Park0Ho-Young Jung1Geon-U Kim2Se-Heon Lee3Jun-Seok Lee4Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of KoreaDepartment of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of KoreaDepartment of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of KoreaDepartment of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of KoreaDepartment of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of KoreaBackground/Objectives: This study investigated whether decompression surgery for lumbar spinal stenosis can effectively improve sagittal alignment in elderly patients. With the growing focus on sagittal balance in spinal surgery, this study aimed to evaluate post-decompression alignment changes and identify the factors influencing these changes using the EOS imaging system. Methods: A retrospective analysis was conducted on 49 elderly patients who underwent decompression surgery alone for lumbar spinal stenosis. Radiologic parameters, measured using the EOS system, and clinical outcomes were assessed preoperatively, at two weeks postoperatively, and at one year postoperatively. Patients were grouped based on the improvement of the sagittal vertical axis (SVA) by 25 mm or more. A multivariate analysis was performed to identify factors affecting sagittal alignment changes. Results: Significant sagittal alignment improvements were observed postoperatively, including a notable increase in thoracic kyphosis and a decrease in SVA observed at one year. Clinical outcomes, such as the Oswestry disability index (ODI) and EQ-5D, significantly improved at both two weeks and one year postoperatively compared to preoperative values (all <i>p</i>-values < 0.05). Multivariate analysis revealed that greater preoperative SVA and higher ODI were significant predictors of sagittal alignment changes (odds ratio [OR] for SVA = 1.014, OR for ODI = 1.034). Conclusions: Decompression surgery for lumbar spinal stenosis in elderly patients can result in significant improvements in sagittal alignment and clinical outcomes. The study suggests that decompression alone is a viable surgical option for elderly patients, particularly those with a greater preoperative sagittal imbalance and disability, even in the absence of major deformities.https://www.mdpi.com/2075-4418/14/21/2380decompressionlumbar spinal stenosissagittal alignmentEOS imaging system |
| spellingShingle | Hyung-Youl Park Ho-Young Jung Geon-U Kim Se-Heon Lee Jun-Seok Lee Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging Analysis Diagnostics decompression lumbar spinal stenosis sagittal alignment EOS imaging system |
| title | Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging Analysis |
| title_full | Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging Analysis |
| title_fullStr | Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging Analysis |
| title_full_unstemmed | Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging Analysis |
| title_short | Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging Analysis |
| title_sort | sagittal realignment following decompression for lumbar spinal stenosis in elderly patients a comprehensive eos imaging analysis |
| topic | decompression lumbar spinal stenosis sagittal alignment EOS imaging system |
| url | https://www.mdpi.com/2075-4418/14/21/2380 |
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