Impact of lumbar fusion on sitting spinopelvic balance: Multisegmental versus monosegmental,Clinical Neurology and Neurosurgery

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Impact of lumbar fusion on sitting spinopelvic balance: Multisegmental versus monosegmental
Clinical Neurology and Neurosurgery ( IF 1.8 ) Pub Date : 2021-08-27 , DOI: 10.1016/j.clineuro.2021.106905
Sinian Wang ₁ , Qingshuang Zhou ₁ , Liang Xu ₁ , Muyi Wang ₁ , Yong Qiu ₁ , Zezhang Zhu ₁ , Bin Wang ₁ , Xu Sun ₁

Affiliation

Objectives

To compare the differences in sagittal spinopelvic parameters between patients receiving monosegmental or multisegmental lumbar fusion and to assess the impact of fusion length on sitting balance.

Methods

The current study recruited 41 patients who had undergone lumbar fusion, consisting of 18 in the monosegmental group and 23 in the multisegmental group. And the control group included 50 lumbar degenerative patients who had no previous spinal fusion surgery. Spinopelvic parameters of patients were assessed: sagittal vertical axis, pelvic tilt, sacral slope, pelvic incidence, thoracic kyphosis, lumbar lordosis, and proximal femur angles.

Results

We observed significant differences in sitting TK (P = 0.031), LL (P = 0.012), PT (P = 0.009) and SVA (P = 0.009) among the three groups. When transitioning from standing to sitting, the multisegmental group had the least change in SVA (P = 0.016), PT (P = 0.043), and LL (P = 0.009), with a compensatory increase in TK (P = 0.021). Moderate to strong correlations were found between the change in the LL and those in the SVA (r = −0.548, P = 0.001), PT (r = −0.600, P = 0.001), and SS (r = 0.623, P = 0.001).

Conclusion

Multisegmental lumbar fusion significantly limits the lumbar mobility and affects the ability to compensate postural changes. Reducing the fusion segments as much as possible is of particular value in preserving lumbar mobility and maintaining the compensatory mechanism of spinopelvis.

中文翻译：

腰椎融合对坐位脊柱骨盆平衡的影响：多节段与单节段

目标

比较接受单节段或多节段腰椎融合术的患者之间矢状面脊柱骨盆参数的差异，并评估融合长度对坐姿平衡的影响。

方法

本研究招募了 41 名接受过腰椎融合术的患者，其中单节段组 18 名，多节段组 23 名。对照组包括50名腰椎退行性病变患者，他们之前没有接受过脊柱融合手术。评估患者的脊柱骨盆参数：矢状垂直轴、骨盆倾斜度、骶骨倾斜度、骨盆入射角、胸椎后凸、腰椎前凸和股骨近端角度。

结果

我们观察到三组在坐姿 TK (P = 0.031)、LL (P = 0.012)、PT (P = 0.009) 和 SVA (P = 0.009) 方面存在显着差异。从站立过渡到坐姿时，多节段组的 SVA (P = 0.016)、PT (P = 0.043) 和 LL (P = 0.009) 变化最小，TK 补偿性增加 (P = 0.021)。在 LL 的变化与 SVA (r = -0.548, P = 0.001)、PT (r = -0.600, P = 0.001) 和 SS (r = 0.623, P = 0.001) 的变化之间发现了中度至强相关性）。