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Reduction of spondylolisthesis and sagittal balance correction by anterior lumbar interbody fusion (ALIF)

Abstract

Purpose

Long time recognized as a cause of lumbar stenosis, degenerative spondylolisthesis has an evolution in interrelation with sagittal balance. This study aimed to assess the role of ALIF in correcting the sagittal balance in patients with degenerative spondylolisthesis.

Material and methods

Twenty patients aged between 47 and 70 years were operated between July 2011 and September 2014 for degenerative spondylolisthesis by ALIF. The pre-operative and post-operative valid standing full spine radiographs were reviewed retrospectively. Clinical and radiological evaluations were conducted pre-operatively and postoperatively at one year and five years.

Results

Lumbar lordosis (LL) was measured to 41.16 ± 14.25° pre-operatively and 47.27 ± 11.25° post-operatively (p > 0.05). At one year was 49.76 ± 13.31° and at five years 46.93 ± 9.26° (p > 0.05). Mean gain of lordosis after ALIF at index level was calculated to 8 ± 1.6° [4–12°].

Conclusions

ALIF offers a good reduction of the slipped vertebra providing good conditions for fusion and is an efficient surgical technique to recreate the sagittal spine balance.

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References

  1. Labelle H, Roussouly P, Berthonnaud É, Transfeldt E, O’Brien M, Chopin D et al (2004) Spondylolisthesis, pelvic incidence, and spinopelvic balance. Spine 29(18):2049–2054. https://doi.org/10.1097/01.brs.0000138279.53439.cc

    Article  PubMed  Google Scholar 

  2. Duval-Beaupère G, Schmidt C, Cosson P (1992) A barycentremetric study of the sagittal shape of spine and pelvis: the conditions required for an economic standing position. Ann Biomed Eng 20(4):451–462. https://doi.org/10.1007/bf02368136

    Article  PubMed  Google Scholar 

  3. Meyerding HW (1931) Sponylolisthesis. J Bone Joint Surg 13(1):39–48

    Google Scholar 

  4. Wiltse LL, Newman PH, Macnab I (1976) Classification of spondylolisis and Spondylolisthesis. Clin Orthop Relat Res (117):23–29. https://doi.org/10.1097/00003086-197606000-00003

  5. Mac-Thiong J, Wang Z, de Guise J, Labelle H (2008) Postural model of sagittal Spino-pelvic alignment and its relevance for lumbosacral developmental Spondylolisthesis. Spine 33(21):2316–2325. https://doi.org/10.1097/brs.0b013e318186b236

    Article  PubMed  Google Scholar 

  6. Vialle R, Levassor N, Rillardon L, Templier A, Skalli W, Guigui P (2005) Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg 87(2):260–267. https://doi.org/10.2106/jbjs.d.02043

    Article  PubMed  Google Scholar 

  7. Kanayama M, Oha F, Hashimoto T (2015) What types of degenerative lumbar pathologies respond to nerve root injection? A retrospective review of six hundred and forty-one cases. Int Orthop 39(7):1379–1382. https://doi.org/10.1007/s00264-015-2761-3

    Article  PubMed  Google Scholar 

  8. Labelle H, Mac-Thiong J, Roussouly P (2011) Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J 20(S5):641–646. https://doi.org/10.1007/s00586-011-1932-1

    Article  PubMed  PubMed Central  Google Scholar 

  9. Labelle H, Roussouly P, Berthonnaud É, Dimnet J, O’Brien M (2005) The importance of spino-pelvic balance in L5–S1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine 30(6S):S27–S34. https://doi.org/10.1097/01.brs.0000155560.92580.90

    Article  PubMed  Google Scholar 

  10. Le Huec J, Faundez A, Dominguez D, Hoffmeyer P, Aunoble S (2014) Evidence showing the relationship between sagittal balance and clinical outcomes in surgical treatment of degenerative spinal diseases: a literature review. Int Orthop 39(1):87–95. https://doi.org/10.1007/s00264-014-2516-6

    Article  PubMed  Google Scholar 

  11. Mardare M, Oprea M, Popa I, Zazgyva A, Niculescu M, Poenaru D (2016) Sagittal balance parameters correlate with spinal conformational type and MRI changes in lumbar degenerative disc disease: results of a retrospective study. Eur J Orthop Surg Traumatol 26(7):735–743. https://doi.org/10.1007/s00590-016-1842-3

    Article  PubMed  Google Scholar 

  12. Berjano P, Langella F, Ismael M, Damilano M, Scopetta S, Lamartina C (2014) Successful correction of sagittal imbalance can be calculated on the basis of pelvic incidence and age. Eur Spine J 23(S6):587–596. https://doi.org/10.1007/s00586-014-3556-8

    Article  PubMed  Google Scholar 

  13. Garcia R, Choy W, DiDomenico J, Barrington N, Dahdaleh N, Rodriguez H et al (2016) Thirty-day readmission rate and risk factors for patients undergoing single level elective anterior lumbar interbody fusion (ALIF). J Clin Neurosci 32:104–108. https://doi.org/10.1016/j.jocn.2016.04.003

    Article  PubMed  Google Scholar 

  14. Wang Y, Chen K, Chen H, Zhang K, Lu J, Mao H, Yang H (2019) Comparison between free-hand and O-arm-based navigated posterior lumbar interbody fusion in elderly cohorts with three-level lumbar degenerative disease. Int Orthop 43(2):351–357. https://doi.org/10.1007/s00264-018-4005-9

    Article  PubMed  Google Scholar 

  15. Champain S, Benchikh K, Nogier A, Mazel C, Guise J, Skalli W (2005) Validation of new clinical quantitative analysis software applicable in spine orthopaedic studies. Eur Spine J 15(6):982–991. https://doi.org/10.1007/s00586-005-0927-1

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ito Z, Imagama S, Kanemura T, Hachiya Y, Miura Y, Kamiya M et al (2013) Bone union rate with autologous iliac bone versus local bone graft in posterior lumbar interbody fusion (PLIF): a multicenter study. Eur Spine J 22(5):1158–1163. https://doi.org/10.1007/s00586-012-2593-4

    Article  PubMed  PubMed Central  Google Scholar 

  17. Glassman S, Bridwell K, Dimar J, Horton W, Berven S, Schwab F (2005) The impact of positive sagittal balance in adult spinal deformity. Spine 30(18):2024–2029. https://doi.org/10.1097/01.brs.0000179086.30449.96

    Article  PubMed  Google Scholar 

  18. Mac-Thiong J, Transfeldt E, Mehbod A, Perra J, Denis F, Garvey T et al (2009) Can C7 Plumbline and gravity line predict health related quality of life in adult scoliosis? Spine 34(15):E519–E527. https://doi.org/10.1097/brs.0b013e3181a9c7ad

    Article  PubMed  Google Scholar 

  19. Faur C, Patrascu J, Haragus H, Anglitoiu B (2019) Correlation between multifidus fatty atrophy and lumbar disc degeneration in low back pain. BMC Musculoskelet Disord 20(1). https://doi.org/10.1186/s12891-019-2786-7

  20. Lazennec J, Ramaré S, Arafati N, Laudet C, Gorin M, Roger B et al (2000) Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J 9(1):47–55. https://doi.org/10.1007/s005860050008

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  21. Saville P, Kadam A, Smith H, Arlet V (2016) Anterior hyperlordotic cages: early experience and radiographic results. Global Spine J 6(1_suppl):s-0036-1583068-s-0036-1583068. https://doi.org/10.1055/s-0036-1583068

    Article  Google Scholar 

  22. Hosseini P, Mundis G, Eastlack R, Bagheri R, Vargas E, Tran S, Akbarnia B (2017) Preliminary results of anterior lumbar interbody fusion, anterior column realignment for the treatment of sagittal malalignment. Neurosurg Focus 43(6):E6. https://doi.org/10.3171/2017.8.focus17423

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank to Andreea Isabela Cuciureanu for the drawings which she made to illustrate this study.

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Correspondence to Iulian Popa.

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Caprariu, R., Popa, I., Oprea, M. et al. Reduction of spondylolisthesis and sagittal balance correction by anterior lumbar interbody fusion (ALIF). International Orthopaedics (SICOT) 45, 997–1001 (2021). https://doi.org/10.1007/s00264-020-04900-7

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Keywords

  • Spinal stenosis
  • Spinopelvic parameters
  • Intervertebral cage
  • Pelvic retroversion