Abstract：
METHODS: Retrospective Cohort Study.
OBJECTIVE: Restoration of lumbar lordosis (LL) is a principal objective during spinal fusion procedures, traditionally focusing on achieving an LL within 10° of the pelvic incidence (PI). Recent studies have demonstrated a relatively constant L4-S1 alignment of 35-40° at L4-S1 and at least 15° at L4-5, regardless of PI. Based on these results, this study was created to examine the success rate of achieving a minimum of 15° at L4-5 through two differing prone-based techniques: Prone Lateral (pLLIF) and Trans Foraminal Interbody Fusion (TLIF).
METHODS: One hundred patients with a primary single-level L4-5 interbody fusion (50 pLLIF and 50 TLIF) were retrospectively analyzed. Pre and post-operative radiographs were measured to examine the segmental change at each level in the lumbar spine and calculate the success rate for achieving a minimum L4-5 segmental lordosis of 15° at the final follow-up.
RESULTS: The overall success rate of achieving an L4-5 segmental alignment >15° at the final follow-up was 70%. Prone LLIF was significantly more likely than TLIF to achieve this goal, achieving L4-5 > 15° 84% of the time vs TLIFs 56% (P = 0.002). Prone LLIF demonstrated an average L4-5 increase of 5.6 ± 5.9° which was larger than the mean increase for TLIF 0.4 ± 3.8° (P < 0.001). In both techniques, there was an inverse correlation between pre-operative L4-5 angle and L4-5 angle change.
CONCLUSIONS: Prone lateral lumbar interbody fusion demonstrates a high success rate for achieving a post-operative L4-5 angle >15° and achieves this at a higher rate than TLIF.
OBJECTIVE: Restoration of lumbar lordosis (LL) is a principal objective during spinal fusion procedures, traditionally focusing on achieving an LL within 10° of the pelvic incidence (PI). Recent studies have demonstrated a relatively constant L4-S1 alignment of 35-40° at L4-S1 and at least 15° at L4-5, regardless of PI. Based on these results, this study was created to examine the success rate of achieving a minimum of 15° at L4-5 through two differing prone-based techniques: Prone Lateral (pLLIF) and Trans Foraminal Interbody Fusion (TLIF).
METHODS: One hundred patients with a primary single-level L4-5 interbody fusion (50 pLLIF and 50 TLIF) were retrospectively analyzed. Pre and post-operative radiographs were measured to examine the segmental change at each level in the lumbar spine and calculate the success rate for achieving a minimum L4-5 segmental lordosis of 15° at the final follow-up.
RESULTS: The overall success rate of achieving an L4-5 segmental alignment >15° at the final follow-up was 70%. Prone LLIF was significantly more likely than TLIF to achieve this goal, achieving L4-5 > 15° 84% of the time vs TLIFs 56% (P = 0.002). Prone LLIF demonstrated an average L4-5 increase of 5.6 ± 5.9° which was larger than the mean increase for TLIF 0.4 ± 3.8° (P < 0.001). In both techniques, there was an inverse correlation between pre-operative L4-5 angle and L4-5 angle change.
CONCLUSIONS: Prone lateral lumbar interbody fusion demonstrates a high success rate for achieving a post-operative L4-5 angle >15° and achieves this at a higher rate than TLIF.
摘要：
方法：回顾性队列研究。
目的：腰椎前凸（LL）的恢复是脊柱融合术的主要目标，传统上专注于在骨盆发生率（PI）的10°内实现LL。最近的研究已经证明,无论PI如何,在L4-S1处35-40°和在L4-5处至少15°的相对恒定的L4-S1对准。基于这些结果,这项研究旨在通过两种不同的基于倾向的技术来检查L4-5时达到最小15°的成功率:俯卧侧(pLLIF)和经椎间融合术(TLIF).
方法：回顾性分析100例原发性单级L4-5椎间融合（50pLLIF和50TLIF）患者。测量术前和术后的X光片，以检查腰椎各个水平的节段变化，并计算最终随访时实现15°最小L4-5节段前凸的成功率。
结果：最终随访时实现L4-5节段对齐>15°的总体成功率为70％。俯卧的LLIF比TLIF更有可能实现这一目标，L4-5>15°84%的时间与TLIFs56%(P=0.002)。俯卧LLIF显示平均L4-5增加5.6±5.9°,其大于TLIF的平均增加0.4±3.8°(P<0.001)。在这两种技术中，术前L4-5角度与L4-5角度变化呈负相关.
结论：俯卧侧腰椎椎间融合术显示出实现术后L4-5角度>15°的高成功率，并且以高于TLIF的速率实现。
目的：腰椎前凸（LL）的恢复是脊柱融合术的主要目标，传统上专注于在骨盆发生率（PI）的10°内实现LL。最近的研究已经证明,无论PI如何,在L4-S1处35-40°和在L4-5处至少15°的相对恒定的L4-S1对准。基于这些结果,这项研究旨在通过两种不同的基于倾向的技术来检查L4-5时达到最小15°的成功率:俯卧侧(pLLIF)和经椎间融合术(TLIF).
方法：回顾性分析100例原发性单级L4-5椎间融合（50pLLIF和50TLIF）患者。测量术前和术后的X光片，以检查腰椎各个水平的节段变化，并计算最终随访时实现15°最小L4-5节段前凸的成功率。
结果：最终随访时实现L4-5节段对齐>15°的总体成功率为70％。俯卧的LLIF比TLIF更有可能实现这一目标，L4-5>15°84%的时间与TLIFs56%(P=0.002)。俯卧LLIF显示平均L4-5增加5.6±5.9°,其大于TLIF的平均增加0.4±3.8°(P<0.001)。在这两种技术中，术前L4-5角度与L4-5角度变化呈负相关.
结论：俯卧侧腰椎椎间融合术显示出实现术后L4-5角度>15°的高成功率，并且以高于TLIF的速率实现。
