TY - JOUR
T1 - Patient Outcomes following Short-segment Lumbar Fusion Are Not Affected by PI-LL Mismatch
AU - DIvi, Srikanth N.
AU - Kepler, Christopher K.
AU - Hilibrand, Alan S.
AU - Goyal, Dhruv K.C.
AU - Mujica, Victor E.
AU - Radcliff, Kristen E.
AU - Anderson, David Greg
AU - Kurd, Mark F.
AU - Rihn, Jeffrey A.
AU - Kaye, Ian D.
AU - Woods, Barrett R.
AU - Vaccaro, Alexander R.
AU - Schroeder, Gregory D.
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - Study Design:This is a retrospective cohort study.Objective:The objective of this study was to further elucidate the relationship between pelvic incidence-lumbar lordosis (PI-LL) mismatch and surgical outcomes in patients undergoing short segment lumbar fusions for degenerative lumbar disease.Summary of Background Data:There are few studies examining the relationship between spinopelvic parameters and patient reported outcome measurements (PROMs) in short segment lumbar degenerative disease.Materials and Methods:A retrospective review was conducted at single academic institution. Patients undergoing 1- or 2-level lumbar fusion were retrospectively identified and separated into 2 groups based on postoperative PI-LL mismatch ≤10 degrees (NM) or PI-LL mismatch >10 degrees (M). Outcomes including the Physical Component Score (PCS)-12, Mental Component Score (MCS)-12, Oswestry Disability Index (ODI), Visual Analog Scale (VAS) back and leg scores were analyzed. Absolute PROM scores, the recovery ratio and the percentage of patients achieving minimum clinically important difference between groups were compared and a multiple linear regression analysis was performed.Results:A total of 306 patients were included, with 59 patients in the NM group and 247 patients in the M group. Patients in the M group started with a higher degree of PI-LL mismatch compared with the NM group (22.2 vs. 7.6 degrees, P<0.001) and this difference increased postoperatively (24.7 vs. 2.5 degrees, P<0.001). There were no differences between the 2 groups in terms of baseline, postoperative, or Δ outcome scores (P>0.05). In addition, having a PI-LL mismatch was not found to be an independent predictor of any PROM on multivariate analysis (P>0.05).Conclusion:The findings in this study show that even though patients in the M group had a higher degree of mismatch preoperatively and postoperatively, there was no difference in PROMs.Level of Evidence:Level III.
AB - Study Design:This is a retrospective cohort study.Objective:The objective of this study was to further elucidate the relationship between pelvic incidence-lumbar lordosis (PI-LL) mismatch and surgical outcomes in patients undergoing short segment lumbar fusions for degenerative lumbar disease.Summary of Background Data:There are few studies examining the relationship between spinopelvic parameters and patient reported outcome measurements (PROMs) in short segment lumbar degenerative disease.Materials and Methods:A retrospective review was conducted at single academic institution. Patients undergoing 1- or 2-level lumbar fusion were retrospectively identified and separated into 2 groups based on postoperative PI-LL mismatch ≤10 degrees (NM) or PI-LL mismatch >10 degrees (M). Outcomes including the Physical Component Score (PCS)-12, Mental Component Score (MCS)-12, Oswestry Disability Index (ODI), Visual Analog Scale (VAS) back and leg scores were analyzed. Absolute PROM scores, the recovery ratio and the percentage of patients achieving minimum clinically important difference between groups were compared and a multiple linear regression analysis was performed.Results:A total of 306 patients were included, with 59 patients in the NM group and 247 patients in the M group. Patients in the M group started with a higher degree of PI-LL mismatch compared with the NM group (22.2 vs. 7.6 degrees, P<0.001) and this difference increased postoperatively (24.7 vs. 2.5 degrees, P<0.001). There were no differences between the 2 groups in terms of baseline, postoperative, or Δ outcome scores (P>0.05). In addition, having a PI-LL mismatch was not found to be an independent predictor of any PROM on multivariate analysis (P>0.05).Conclusion:The findings in this study show that even though patients in the M group had a higher degree of mismatch preoperatively and postoperatively, there was no difference in PROMs.Level of Evidence:Level III.
KW - degenerative disease
KW - lumbar fusion
KW - patient reported outcome measurements (PROMs)
KW - pelvic incidence-lumbar lordosis (PI-LL)
KW - spinopelvic mismatch
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U2 - 10.1097/BSD.0000000000001051
DO - 10.1097/BSD.0000000000001051
M3 - Article
C2 - 33633060
AN - SCOPUS:85101766780
VL - 34
SP - 73
EP - 77
JO - Clinical Spine Surgery
JF - Clinical Spine Surgery
SN - 2380-0186
IS - 2
ER -