Changes in Alignment at Untreated Vertebral Levels Following Short-Segment Fusion Using Personalized Interbody Cages:...

Area of Science:

• Spine surgery
• Orthopedic implants
• Radiographic analysis

Background:

• Abnormal postoperative lordosis distribution index (LDI) is linked to adjacent segment disease and revision surgery after short-segment lumbar fusions.
• Preoperative spinopelvic parameters and LDI are crucial for surgical planning to restore alignment.
• This study investigates LDI and segmental lordosis changes with personalized interbody cage (PIC) implants.

Purpose of the Study:

• To evaluate the effectiveness of PIC implants in restoring lordosis distribution index (LDI).
• To assess changes in segmental lordosis and lordosis of unfused levels post-PIC implantation.
• To determine if PICs can help achieve patient-specific lordosis goals in short-segment lumbar fusions.

Main Methods:

• Retrospective analysis of 111 patients with degenerative spinal conditions.
• Short-segment lumbar fusion (L4-L5, L5-S1, or L4-S1) using PIC implants.
• Preoperative and postoperative radiographic measurements of LDI and intervertebral lordosis were compared.

Main Results:

• Patients with preoperative hypolordotic LDI showed significant improvement postoperatively, nearing the normal LDI range.
• Patients with preoperative hyperlordotic LDI experienced a decrease in LDI, trending towards normal, but not significantly.
• PIC placement significantly increased L5-S1 intervertebral lordosis in normal and hypolordotic LDI groups; no significant changes were observed at L1-L4.

Conclusions:

• PIC implants are beneficial, especially for patients with preoperative hypolordotic distribution.
• PICs assist surgeons in achieving patient-specific lordosis, potentially reducing adjacent segment disease and revision rates.
• Personalized implants can improve patient outcomes by optimizing spinal alignment and minimizing long-term reinterventions.