Yıl: 2022 Cilt: 33 Sayı: 2 Sayfa Aralığı: 43 - 49 Metin Dili: İngilizce DOI: 10.4274/jtss.galenos.2022.57441 İndeks Tarihi: 25-06-2022

THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS

Öz:
Objective: This study assessed the outcomes of transforaminal lumbar interbody fusion (TLIF) in patients with degenerative spine conditions above the age of 65 years and investigate the effects of fusion levels on the sagittal balance parameters. Materials and Methods: This retrospective study reviewed patients with degenerative spine diseases who underwent lumbar fusion with the TLIF procedure older than 65 years. Patients with three or less segments involved in the fusion were assigned to the short-level fusion group, and the patients with more than three segments involved in the fusion were assigned to the long-level fusion group. The anteroposterior and lateral spine radiographs of the patients were used to measure pelvic incidence (PI), pelvic tilt (PT), sacral slop (SS), lumbar lordosis (LL), distal lumbar lordosis, thoracolumbar kyphosis, thoracic kyphosis (TK), T1 spinopelvic inclination (T1SPI), T9 spinopelvic inclination (T9SPI) and T1 pelvic angle (TPA). Results: The study included 45 patients, 28 females and 17 males, who met the inclusion criteria. The long- and short-level fusion groups comprised 25 and 20 patients, with the mean ages of 68.87 and 67.72 years and mean follow-up periods of 26.96±15.53 and 27.61±11.83 months, respectively. TK and T9SPI values showed no difference between the groups before and after surgery, but a statistically significant increase in the values was observed postoperatively in the patients who underwent long-level fusion. The preoperative SVA values were significantly higher in the long-level fusion group than in the short-level fusion group. No difference in the postoperative SVA values was found between the groups. The PT, PI, SS, TPA, T1SPI was not statistically differ between the groups before and after surgery. Conclusion: TLIF contributes to the improvement of the sagittal balance parameters in both short- and long-level fusions in patients above the age of 65 years with degenerative spine conditions.
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  • 1. Gallucci M, Limbucci N, Paonessa A, Splendiani A. Degenerative disease of the spine. Neuroimaging Clin N Am. 2007;17:87-103.
  • 2. Gallucci M, Puglielli E, Splendiani A, Pistoia F, Spacca G. Degenerative disorders of the spine. Eur Radiol. 2005;15:591-8.
  • 3. Resnick D. Degenerative diseases of the vertebral column. Radiology. 1985;156:3-14.
  • 4. Fleege C, Rickert M, Rauschmann M. PLIF- und TLIF-Verfahren. Indikation, Technik, Vor- und Nachteile [The PLIF and TLIF techniques. Indication, technique, advantages, and disadvantages]. Orthopade. 2015;44:114-23.
  • 5. Patel JY, Kundnani VG, Chawada B. Is Older Age a Contraindication for Single-Level Transforaminal Lumbar Interbody Fusion? Asian Spine J. 2021;15:447-54.
  • 6. Cheng X, Zhang F, Zhang K, Sun X, Zhao C, Li H, et al. Effect of Single-Level Transforaminal Lumbar Interbody Fusion on Segmental and Overall Lumbar Lordosis in Patients with Lumbar Degenerative Disease. World Neurosurg. 2018;109:e244-51.
  • 7. Gunzburg R, Szpalski M. The conservative surgical treatment of lumbar spinal stenosis in the elderly. Eur Spine J. 2003;12 Suppl 2:S176-80.
  • 8. Ciol MA, Deyo RA, Howell E, Kreif S. An assessment of surgery for spinal stenosis: time trends, geographic variations, complications, and reoperations. J Am Geriatr Soc. 1996;44:285-90.
  • 9. Chen PG, Daubs MD, Berven S, Raaen LB, Anderson AT, Asch SM, et al. Surgery for Degenerative Lumbar Scoliosis: The Development of Appropriateness Criteria. Spine (Phila Pa 1976). 2016;41:910-8.
  • 10. Phan K, Xu J, Maharaj MM, Li J, Kim JS, Di Capua J, et al. Outcomes of Short Fusion versus Long Fusion for Adult Degenerative Scoliosis: A Systematic Review and Meta-analysis. Orthop Surg. 2017;9:342-9.
  • 11. Liu W, Chen XS, Jia LS, Song DW. The clinical features and surgical treatment of degenerative lumbar scoliosis: a review of 112 patients. Orthop Surg. 2009;1:176-83.
  • 12. Pritchett JW, Bortel DT. Degenerative symptomatic lumbar scoliosis. Spine (Phila Pa 1976). 1993;18:700-3.
  • 13. Aebi M. The adult scoliosis. Eur Spine J. 2005;14:925-48.
  • 14. Vaccaro AR, Ball ST. Indications for instrumentation in degenerative lumbar spinal disorders. Orthopedics. 2000;23:260-71; quiz 272-3.
  • 15. Daffner SD, Vaccaro AR. Adult degenerative lumbar scoliosis. Am J Orthop (Belle Mead NJ). 2003;32:77-82.
  • 16. Jagannathan J, Sansur CA, Oskouian RJ Jr, Fu KM, Shaffrey CI. Radiographic restoration of lumbar alignment after transforaminal lumbar interbody fusion. Neurosurgery. 2009;64:955-64.
  • 17. Hsu HT, Yang SS, Chen TY. The Correlation Between Restoration of Lumbar Lordosis and Surgical Outcome in the Treatment of Lowgrade Lumbar Degenerative Spondylolisthesis With Spinal Fusion. Clin Spine Surg. 2016;29:E16-20.
  • 18. Kumar MN, Baklanov A, Chopin D. Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J. 2001;10:314-9.
  • 19. Hsieh PC, Koski TR, O’Shaughnessy BA, Sugrue P, Salehi S, Ondra S, et al. Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion: implications for the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance. J Neurosurg Spine. 2007;7:379-86.
  • 20. Kim SB, Jeon TS, Heo YM, Lee WS, Yi JW, Kim TK, et al. Radiographic results of single level transforaminal lumbar interbody fusion in degenerative lumbar spine disease: focusing on changes of segmental lordosis in fusion segment. Clin Orthop Surg. 2009;1:207-13.
  • 21. Kepler CK, Rihn JA, Radcliff KE, Patel AA, Anderson DG, Vaccaro AR, et al. Restoration of lordosis and disk height after single-level transforaminal lumbar interbody fusion. Orthop Surg. 2012;4:15-20.
  • 22. Glattes RC, Bridwell KH, Lenke LG, Kim YJ, Rinella A, Edwards C 2nd. Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976). 2005;30:1643-9.
  • 23. Kim HJ, Iyer S. Proximal Junctional Kyphosis. J Am Acad Orthop Surg. 2016;24:318-26.
  • 24. Kim YJ, Bridwell KH, Lenke LG, Glattes CR, Rhim S, Cheh G. Proximal junctional kyphosis in adult spinal deformity after segmental posterior spinal instrumentation and fusion: minimum five-year follow-up. Spine (Phila Pa 1976). 2008;33:2179-84.
  • 25. Li Y, Ou Y, Zhu Y, He B, Xu S, Yu H. Effectiveness of Short-Segment Fixation versus Long-Segment Fixation for Degenerative Scoliosis with Cobb Angle 20°~40°: A Retrospective Observational Study. Med Sci Monit. 2020;26:e923656.
APA ÖZDEMİR m, Karalar Ş, Korkmaz M, TOPAK D, YAĞCI T, PEHLIVANOGLU T, akgul t (2022). THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. , 43 - 49. 10.4274/jtss.galenos.2022.57441
Chicago ÖZDEMİR mustafa,Karalar Şahin,Korkmaz Murat,TOPAK DURAN,YAĞCI Taha Furkan,PEHLIVANOGLU Tuna,akgul turgut THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. (2022): 43 - 49. 10.4274/jtss.galenos.2022.57441
MLA ÖZDEMİR mustafa,Karalar Şahin,Korkmaz Murat,TOPAK DURAN,YAĞCI Taha Furkan,PEHLIVANOGLU Tuna,akgul turgut THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. , 2022, ss.43 - 49. 10.4274/jtss.galenos.2022.57441
AMA ÖZDEMİR m,Karalar Ş,Korkmaz M,TOPAK D,YAĞCI T,PEHLIVANOGLU T,akgul t THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. . 2022; 43 - 49. 10.4274/jtss.galenos.2022.57441
Vancouver ÖZDEMİR m,Karalar Ş,Korkmaz M,TOPAK D,YAĞCI T,PEHLIVANOGLU T,akgul t THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. . 2022; 43 - 49. 10.4274/jtss.galenos.2022.57441
IEEE ÖZDEMİR m,Karalar Ş,Korkmaz M,TOPAK D,YAĞCI T,PEHLIVANOGLU T,akgul t "THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS." , ss.43 - 49, 2022. 10.4274/jtss.galenos.2022.57441
ISNAD ÖZDEMİR, mustafa vd. "THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS". (2022), 43-49. https://doi.org/10.4274/jtss.galenos.2022.57441
APA ÖZDEMİR m, Karalar Ş, Korkmaz M, TOPAK D, YAĞCI T, PEHLIVANOGLU T, akgul t (2022). THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. Journal of Turkish Spinal Surgery, 33(2), 43 - 49. 10.4274/jtss.galenos.2022.57441
Chicago ÖZDEMİR mustafa,Karalar Şahin,Korkmaz Murat,TOPAK DURAN,YAĞCI Taha Furkan,PEHLIVANOGLU Tuna,akgul turgut THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. Journal of Turkish Spinal Surgery 33, no.2 (2022): 43 - 49. 10.4274/jtss.galenos.2022.57441
MLA ÖZDEMİR mustafa,Karalar Şahin,Korkmaz Murat,TOPAK DURAN,YAĞCI Taha Furkan,PEHLIVANOGLU Tuna,akgul turgut THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. Journal of Turkish Spinal Surgery, vol.33, no.2, 2022, ss.43 - 49. 10.4274/jtss.galenos.2022.57441
AMA ÖZDEMİR m,Karalar Ş,Korkmaz M,TOPAK D,YAĞCI T,PEHLIVANOGLU T,akgul t THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. Journal of Turkish Spinal Surgery. 2022; 33(2): 43 - 49. 10.4274/jtss.galenos.2022.57441
Vancouver ÖZDEMİR m,Karalar Ş,Korkmaz M,TOPAK D,YAĞCI T,PEHLIVANOGLU T,akgul t THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS. Journal of Turkish Spinal Surgery. 2022; 33(2): 43 - 49. 10.4274/jtss.galenos.2022.57441
IEEE ÖZDEMİR m,Karalar Ş,Korkmaz M,TOPAK D,YAĞCI T,PEHLIVANOGLU T,akgul t "THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS." Journal of Turkish Spinal Surgery, 33, ss.43 - 49, 2022. 10.4274/jtss.galenos.2022.57441
ISNAD ÖZDEMİR, mustafa vd. "THE EFFECT OF LONG- AND SHORT-LEVEL FUSIONS ON SAGITTAL BALANCE PARAMETERS OF PATIENTS TREATED WITH TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR DEGENERATIVE SPINE OVER OLDER THAN 65 YEARS". Journal of Turkish Spinal Surgery 33/2 (2022), 43-49. https://doi.org/10.4274/jtss.galenos.2022.57441