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Radiological improvements in global sagittal alignment after lumbar decompression without fusion
Kengo Fujii1, Naohiro Kawamura, Masachika Ikegami
1*Department of Spine and Orthopedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan; and †Department of Musculoskeletal Oncology, Komagome Hospital, Tokyo Metropolitan Cancer and Infectious Diseases Center, Tokyo, Japan.
Spine
|November 14, 2014
Summary
Lumbar decompression without fusion improved sagittal alignment, increasing lumbar lordosis and thoracic kyphosis. This surgery can correct spinal imbalance, even when present before the procedure.
Area of Science:
- Spine surgery
- Radiological assessment
- Biomechanical analysis
Background:
- Global sagittal balance is increasingly recognized as crucial for spinal health.
- Limited data exists on how lumbar decompression without fusion affects sagittal alignment.
Purpose of the Study:
- To assess short-term radiological changes in sagittal alignment after lumbar decompression without fusion for lumbar canal stenosis.
Main Methods:
- Retrospective review of 88 patients undergoing lumbar decompression without fusion.
- Radiographic analysis of sagittal vertical axis, lumbar lordosis, pelvic tilt, and other parameters pre- and post-operatively.
- Clinical outcomes assessed using Zurich Claudication Questionnaire and visual analogue scale.
Main Results:
- Significant increases in lumbar lordosis and thoracic kyphosis observed post-surgery.
- Significant decreases in sagittal vertical axis, pelvic tilt, and PI-LL were noted.
- No significant changes in occipital-7th cervical angle or pelvic incidence; clinical outcomes did not correlate with radiological changes.
Conclusions:
- Lumbar decompression without fusion can lead to beneficial, reactive changes in lumbar and global sagittal alignment.
- The procedure may improve spinal balance even in patients with preoperative sagittal imbalance.
