Turkish Neurosurgery
Contribution of Multi-level Transformainal Lumbar Interbody Fusion Surgery to Restoration of Sagittal Balance in Patients with Degenerative Spine: Comparison of Long and Short Level Fusion
Mustafa Abdullah OZDEMIR1, Sahin KARALAR2, Murat KORKMAZ2, Serkan BAYRAM 2, Mehmet EKINCI4, Tuna PEHLIVANOGLU3, Turgut AKGUL2
1Kahramanmaraş Sütçü İmam University, Faculty of Medicine, 1 Department of Orthopaedics and Traumatology, Kahramanmaraş/onişubat,
2Istanbul Faculty of Medicine, Istanbul University,, Department of Orthopaedics and Traumatology, İstanbul,
3Yeni Yüzyil University, Faculty of Medicine, Department of Orthopaedics and Traumatology, İstanbul,
4Haseki Education and Research Hospital, Department of Orthopaedics and Traumatology, İstanbul,
DOI: 10.5137/1019-5149.JTN.41633-22.3
Aim:The present study aimed to investigate the effect of multi-level TLIF (Transforaminal lumbar interbody fusion) procedures in degenerative spine conditions on the restoration of sagittal balance.Material and Methods:In this retrospective study we compared the radiological results of patients treated with three or fewer segment fusion assigned as the short-level group (n: 23) and patient with more than three segment fusion as assigned to the long-level group (n: 24) in who underwent lumbar fusion using a multilevel TLIF procedure diagnosed with degenerative spine. The spinopelvic parameter (pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS)), and sagittal spinal balance parameters (lumbar lordosis (LL), distal lumbar lordosis(DLL), thoracolumbar kyphosis (TLK), thoracic kyphosis (TK), T1 spinopelvic inclination (T1SPI), T9 spinopelvic inclination (T9SPI), T1 pelvic angle (TPA) and sagittal vertical axis (SVA)) were measured from lateral spinal radiograph pre and postoperatively.Results:The study included 47 patients who met the inclusion criteria, with a mean age of 60.4 ± 12.2 years. The mean follow-up time of our patients was 18.3 ± 11 months. Thirty-five (74.5%) patients were women and 12 (25.5%) were men. There was a significant difference in the postoperative LL, DLL, and TK measurements in both groups compared with the preoperative period. There were no statistical differences in the pre- and postoperative PT, PI, SS, TPA, and T1SPI between the groups.Conclusion:Multilevel TLIF procedure regardless of long or short level fusion can be used to correct sagittal alignment which improved the LL, DLL, and SVA. However, long level fusion group had improved the SVA better than short level.
Corresponding author : Mustafa Abdullah OZDEMIR