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Impact of lumbar fusion on spinopelvic sagittal alignment from standing to sitting position: which factor is associated with postoperative functional limitations due to lumbar stiffness?

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Abstract

Purpose

To investigate the impact of lumbar fusion on spinopelvic sagittal alignment from standing to sitting position and the influencing factors of postoperative functional limitations due to lumbar stiffness.

Methods

A total of 107 patients who undertook posterior lumbar interbody fusion were included. Patients were divided into two groups: Group A (lumbosacral fusion; n = 43) and Group B (floating fusion; n = 64). Spinopelvic parameters in standing and sitting position including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), fusion segment lordosis (FSL), upper residual lordosis (URL), lower residual lordosis (LRL), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), sagittal vertical axis (SVA) and T1 pelvic angle (TPA) were measured before and after lumbar fusion. The Lumbar Stiffness Disability Index (LSDI) was used to assess functional limitations due to lumbar stiffness.

Results

Accompanied by increased postoperative LSDI, the values of changes from standing to sitting (∆) were reduced in some parameters compared with the preoperative values. ∆PT and ∆SS significantly decreased in both two groups. In Group A, ∆LL significantly decreased with increased ∆URL. In Group B, ∆LL, ∆URL and ∆LRL showed no significant difference before and after surgery. Multiple linear regression analysis showed that age and ∆PT independently influenced the postoperative LSDI in Group A.

Conclusion

After lumbar fusion, changes of lumbopelvic sagittal parameters from standing to sitting would be restricted. Adjacent segment lordosis could partially compensate for this restriction. For patients with lumbosacral fusion, postoperative functional limitations due to lumbar stiffness were related to age and the postoperative ∆PT from standing to sitting.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This article is supported by the National Natural Science Foundation of China (Grant No. 81871807).

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Author notes

  1. Siyu Zhou and Weipeng Qiu have contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China

    Siyu Zhou, Weipeng Qiu, Wei Li, Fei Xu, Da Zou, Zhuoran Sun & Weishi Li

  2. Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China

    Siyu Zhou, Weipeng Qiu, Wei Li, Fei Xu, Da Zou, Zhuoran Sun & Weishi Li

  3. Beijing Key Laboratory of Spinal Disease Research, Beijing, China

    Siyu Zhou, Weipeng Qiu, Wei Li, Fei Xu, Da Zou, Zhuoran Sun & Weishi Li

  4. Department of Orthopaedic, Tianjin Hospital, Tianjin, China

    Wei Wang

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  1. Siyu Zhou
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Correspondence to Weishi Li.

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Zhou, S., Qiu, W., Wang, W. et al. Impact of lumbar fusion on spinopelvic sagittal alignment from standing to sitting position: which factor is associated with postoperative functional limitations due to lumbar stiffness?. Eur Spine J 32, 345–352 (2023). https://doi.org/10.1007/s00586-022-07438-x

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  • DOI: https://doi.org/10.1007/s00586-022-07438-x

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