Abstract
Introduction
The sagittal plane of body produces a convex curve anteriorly referred to as the lordotic curve. Malalignment of lordotic curve leads to low back disorders and lumbar spinal surgery has been known to cause this. This study was a retrospective analysis of the effects of posterior lumbar interbody fusion using cages on segmental lumbar lordosis.
Materials and methods
We conducted a retrospective study involving 27 patients of which 16 were females and 11 were males. All patients underwent single level posterior lumbar interbody fusion with insertion of non-wedged intervertebral cage and pedicle screw fixation. Intraoperatively, all patients had a change from knee chest position to prone to augment their lumbar lordosis. The minimum follow up was 2 years and fusion was achieved in 21 patients.
Results
Segmental lordotic angles increased from 15.2° to 20.6° at L4/5 level and from 17.8° to 24.5° at L5/S1 level, preoperative to postoperative, respectively (P < 0.01 at both levels).
Conclusion
Thus apparently, posterior lumbar interbody fusion with insertion of non-wedged intervertebral cage and pedicle screw fixation results in creation and maintenance of lumbar lordosis.
Résumé
Introduction
Le plan sagittal des corps vertébraux produit une courbe convexe vers l’avant référée comme étant la lordose lombaire. Le mal alignement de cette lordose entraîne des désordres du bas du dos et la chirurgie lombaire est censée créer ces désordres. Cette étude est une analyse rétrospective des effets de l’arthrodèse intersomatique lombaire avec cages placées par voie postérieure sur la lordose segmentaire lombaire.
Matériels et méthode
Nous avons fait cette étude rétrospective chez 27 patients, soit 16 femmes et 11 hommes. Tous les patients furent opérés par pose de cages intersomatiques non cunéiformes à un seul niveau, associée à une ostéosynthèse avec vissage pédiculaire. Pendant l’intervention tous les patients ont été déplacés de la position genu-pectorale au procubitus afin d’augmenter leur lordose lombaire. Le recul moyen a été de deux ans et la fusion a été considérée comme atteinte chez 21 patients.
Résultats
Les angles de lordose lombaire segmentaire ont augmenté de 15.2° à 20.6° en L4/5 et de 17.8° à 24.5° en L5/S1 entre la mensuration pré-opératoire et la post-opératoire (P < 0.01 aux deux niveaux).
Conclusion
On peut en déduire qu’apparemment l’arthrodèse intersomatique par voie postérieure avec insertion de cages non cunéiformes et fixation par vissage pédiculaire crée et maintient la lordose lombaire.
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Kakkar, R., Sirigiri, P.B.R., Howieson, A. et al. Posterior lumbar interbody fusion and segmental lumbar lordosis. Eur J Orthop Surg Traumatol 17, 125–129 (2007). https://doi.org/10.1007/s00590-006-0137-5
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DOI: https://doi.org/10.1007/s00590-006-0137-5