Radiographic Analysis of the Spinopelvic Parameters Obtained With an Anterior TLIF Device. Multicenter Study
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Published:
Dec 31, 2022
Keywords:
TLIF, anterior TLIF, interbody fusion, posterior approach, lordosis
Main Article Content
Abstract
Objective: To report the results obtained according to the position of an anterior TLIF device.
Materials and Methods: Multicenter, observational, analytical, cross-sectional, retrospective recovery study. We evaluated the pre and post-operative spinopelvic parameters of the spinograms of 20 patients who underwent surgery between September 2019 and August 2021. Patients who had undergone lumbar arthrodesis with an anterior TLIF implant were included, whereas patients without a pre or post-surgical spinogram and more than one device were excluded.
Results: The mean monosegmental lordosis was 13.33° preoperatively and 18.81° postoperatively (p <0.001). The mean monosegmental lordosis was 7.32°, 2.95°, and 6.24° for positions I, II, and III, respectively. The mean disc height was 6.22 mm for the preoperative period and 11.06 mm for the postoperative period (p >0.001).
Conclusion: We found encouraging results on the placement of this type of device and its relationship with segmental lordosis, understanding the importance of its placement at the anterior end of the disc space.
Level of Evidence: IV
Materials and Methods: Multicenter, observational, analytical, cross-sectional, retrospective recovery study. We evaluated the pre and post-operative spinopelvic parameters of the spinograms of 20 patients who underwent surgery between September 2019 and August 2021. Patients who had undergone lumbar arthrodesis with an anterior TLIF implant were included, whereas patients without a pre or post-surgical spinogram and more than one device were excluded.
Results: The mean monosegmental lordosis was 13.33° preoperatively and 18.81° postoperatively (p <0.001). The mean monosegmental lordosis was 7.32°, 2.95°, and 6.24° for positions I, II, and III, respectively. The mean disc height was 6.22 mm for the preoperative period and 11.06 mm for the postoperative period (p >0.001).
Conclusion: We found encouraging results on the placement of this type of device and its relationship with segmental lordosis, understanding the importance of its placement at the anterior end of the disc space.
Level of Evidence: IV
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How to Cite
Gobbi, E. A., de Zavalía, M., Lanari Zubiaur, F., Berjano, R., Ortiz, F., Zuliani, P., & Pons Belmonte, R. (2022). Radiographic Analysis of the Spinopelvic Parameters Obtained With an Anterior TLIF Device. Multicenter Study. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(6), 748-755. https://doi.org/10.15417/issn.1852-7434.2022.87.6.1460
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Clinical Research
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19. Jiang SD, Chen JW, Jiang LS. Which procedure is better for lumbar interbody fusion: anterior lumbar interbody
fusion or transforaminal lumbar interbody fusion? Arch Orthop Trauma Surg 2012;132(9):1259-66.
https://doi.org/10.1007/s00402-012-1546-z
20. Formica M, Quarto E, Zanirato A, Mosconi L, Lontaro-Baracchini M, Alessio-Mazzola, et al. ALIF in the correction of spinal sagittal misalignment. A systematic review of literature. Eur Spine J 2021;30(1):50-62.
https://doi.org/10.1007/s00586-020-06598-y
1944;26(1):125-30. Disponible en: http://citeseerx.ist.psu.edu/viewdoc/download doi=10.1.1.978.6512&rep=rep1&type=pdf
2. Mummaneni PV, Hussain I, Shaffrey CI, Eastlack RK, Mundis GM, Uribe JS, et al. The minimally invasive
interbody selection algorithm for spinal deformity. J Neurosurg Spine 2021;34(5):741-8. https://doi.org/10.3171/2020.9.SPINE20230
3. Cloward RB. The treatment of ruptured lumbar intervertebral discs by vertebral body fusion. I. Indications,
operative technique, after care: I. Indications, operative technique, after care. J Neurosurg 1953;10(2):154-68.
https://doi.org/10.3171/jns.1953.10.2.0154
4. Harms JG, Jeszenszky D. Die posteriore, lumbale, interkorporelle Fusion in unilateraler transforaminaler Technik. Oper Orthop Traumatol 1998;10:90-102. https://doi.org/10.1007/s00064-006-0112-7
5. de Kunder SL, van Kuijk SMJ, Rijkers K, Caelers IJMH, van Hemert WLW, de Bie RA, et al. Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a systematic review and meta-analysis. Spine J 2017;17(11):1712-21. https://doi.org/10.1016/j.spinee.2017.06.018
6. Glassman SD, Berven S, Bridwell K, Horton W, Dimar JR. Correlation of radiographic parameters and clinical
symptoms in adult scoliosis. Spine (Phila Pa 1976) 2005;30(6):682-8. https://doi.org/10.1097/01.brs.0000155425.04536.f7
7. Mehta VA, Amin A, Omeis I, Gokaslan ZL, Gottfried ON. Implications of spinopelvic alignment for the spine
surgeon. Neurosurgery 2012;70(3):707-21. https://doi.org/10.1097/01.brs.0000155425.04536.f7
8. Hsieh PC, Koski TR, O’Shaughnessy BA, Sugrue P, Salehi S, Ondra S, et al. Anterior lumbar interbody fusion in
comparison with transforaminal lumbar interbody fusion: implications for the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance. J Neurosurg Spine 2007;7(4):379-86. https://doi.org/10.3171/SPI-07/10/379
9. Kim J-S, Lee K-Y, Lee S-H, Lee H-Y. Which lumbar interbody fusion technique is better in terms of level for the
treatment of unstable isthmic spondylolisthesis? Clinical article. J Neurosurg Spine 2010;12(2):171-7.
https://doi.org/10.3171/2009.9.SPINE09272
10. Landham PR, Don AS, Robertson PA. Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction. Eur Spine J 2017;26(11):2843-50. https://doi.org/10.1007/s00586-017-5170-z
11. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: Lumbar fusion for stenosis with spondylolisthesis. J Neurosurg Spine 2014;21:54-61. https://doi.org/10.3171/2014.4.SPINE14274
12. Teng I, Han J, Phan K, Mobbs R. A meta-analysis comparing ALIF, PLIF, TLIF and LLIF. J Clin Neurosci
2017;44:11-7. https://10.1016/j.jocn.2017.06.013
13. Phan K, Thayaparan GK, Mobbs RJ. Anterior lumbar interbody fusion versus transforaminal lumbar interbody
fusion - systematic review and meta-analysis. Br J Neurosurg 2015;29:705-11. https://doi.org/10.3109/02688697.2015.1036838
14. Rymarczuk GN, Harrop JS, Hilis A, Härtl R. Should expandable TLIF cages be used routinely to increase lordosis? Clin Spine Surg 2017;30(2):47-9. https://doi.org/10.1097/BSD.0000000000000510
15. Wang MY. Improvement of sagittal balance and lumbar lordosis following less invasive adult spinal deformity
surgery with expandable cages and percutaneous instrumentation: Clinical article. J Neurosurg Spine 2013;18(1):4-12. https://doi.org/10.3171/2012.9.SPINE111081
16. Faundez AA, Mehbod AA, Wu C, Wu H, Ploumis A, Transfeldt EE. Position of inter- body spacer in transforaminal lumbar interbody fusion: effect on 3-dimensional stability and sagittal lumbar contour. J Spinal Disord Tech 2008;21(175-180):0 013 318074 7. https://doi.org/10.1097/BSD.0b013e318074bb7d
17. Kepler CK, Rihn JA, Ke R. Restoration of lordosis and disk height after single-level transforaminal lumbar
interbody fusion. Orthop Surg 2012;4(1):15-20. https://doi.org/10.1111/j.1757-7861.2011.00165.x
18. Rothrock RJ, McNeill IT, Yaeger K, Oermann EK, Cho SK, Caridi JM. Lumbar lordosis correction with interbody
fusion: Systematic literature review and analysis. World Neurosurg 2018;118:21-31. https://doi.org/10.1016/j.wneu.2018.06.216
19. Jiang SD, Chen JW, Jiang LS. Which procedure is better for lumbar interbody fusion: anterior lumbar interbody
fusion or transforaminal lumbar interbody fusion? Arch Orthop Trauma Surg 2012;132(9):1259-66.
https://doi.org/10.1007/s00402-012-1546-z
20. Formica M, Quarto E, Zanirato A, Mosconi L, Lontaro-Baracchini M, Alessio-Mazzola, et al. ALIF in the correction of spinal sagittal misalignment. A systematic review of literature. Eur Spine J 2021;30(1):50-62.
https://doi.org/10.1007/s00586-020-06598-y