Radiological and clinical outcomes of midline lumbar fusion on sagittal lumbar-pelvic parameters for degenerative lumbar diseases

doi:10.12998/wjcc.v10.i35.12880

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World Journal of Clinical Cases

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World J Clin Cases. Dec 16, 2022; 10(35): 12880-12889
Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12880

Table 1 Comparison of baseline data between the midline lumbar fusion and minimally invasive transforaminal lumbar interbody fusion groups

	MIDLF (n = 34)	MIS-TLIF (n = 29)	P value
Age (yr)	62.94 ± 13.03	58.76 ± 8.65	0.146
Gender (male/female)	14/20	16/13	0.268
BMI (kg/cm²)	25.82 ± 3.81	26.06 ± 3.68	0.802
Main diagnosis
Lumbar spinal stenosis	20	8
Lumbar disc herniation	11	19
Lumbar spondylolisthesis	3	2
Operation segment
L3-4	2	0
L4-5	25	20
L5-S1	7	9
Operation duration (min)	227.88 ± 35.53	240.24 ± 38.47	0.190
Estimated blood loss (mL)	400 (200-600)	300 (150-500)	0.013^a
Hospital stay time (d)	7 (4-11)	6 (3-11)	0.085
Follow-up time (mo)	15.65 ± 2.65	15.31 ± 1.85	0.568

^aP < 0.05.

BMI: Body mass index; MIDLF: Midline lumbar fusion; MIS-TLIF: Minimally invasive transforaminal lumbar interbody.

Table 2 Sagittal lumbar-pelvic parameters of the midline lumbar fusion and minimally invasive transforaminal lumbar interbody fusion groups

	MIDLF (n = 34)	MIS-TLIF (n = 29)	P value
LL
Preoperative	35.74 ± 14.77	35.17 ± 13.50	0.875
Final follow-up	41.45 ± 12.83	41.21 ± 12.11	0.940
ΔLL	5.48 (-14.13, 33.86)	5.34 (-14.35, 33.85)	0.772
P value (pre-final)	0.005^a	0.002^a
Lower LL
Preoperative	23.21 ± 9.65	22.21 ± 9.90	0.688
Final follow-up	27.57 ± 8.00	26.49 ± 8.74	0.609
ΔLower LL	4.24 (-11.43, 24.02)	4.27 ± 7.19	0.472
P value (pre-final)	0.001^a	0.003^a
L4S
Preoperative	3.79 ± 8.03	4.81 ± 7.70	0.611
Final follow-up	2.65 ± 8.69	4.14 ± 8.35	0.492
ΔL4S	-1.06 (-13.06, 12.83)	-0.63 (-12.74, 13.22)	0.180
P value (pre-final)	0.029^a	0.157
L5S
Preoperative	11.42 ± 7.63	12.74 ± 7.53	0.494
Final follow-up	11.16 ± 9.04	14.44 ± 14.78	0.284
ΔL5S	-0.27 (-10.97, 25.62)	2.58 (-16.20, 41.31)	0.562
P value (pre-final)	0.204	0.673
L5I
Preoperative	21.99 (8.01-55.98)	23.26 (12.15-56.93)	0.270
Final follow-up	19.67 (9.21-44.23)	22.62 ± 9.91	0.440
ΔL5I	-2.08 (15.33-22.47)	-2.65 (-15.77, 21.61)	0.184
P value (pre-final)	0.02^a	0.001^a
LASD
Preoperative	9.04 ± 23.11	14.24 ± 22.70	0.374
Final follow-up	2.80 ± 20.12	4.26 ± 20.85	0.779
ΔLASD	-6.23 (-47.71, 32.43)	-7.91 (-49.24, 30.84)	0.038^a
P value (pre-final)	0.002^a	0.000^a
PI
Preoperative	46.73 ± 10.43	49.15 ± 10.81	0.369
Final follow-up	46.49 ± 11.38	50.21 ± 13.26	0.189
ΔPI	-0.94 (-7.93, 38.08)	0.49 (-8.15, 38.13)	0.319
P value (pre-final)	0.062	0.754
PT
Preoperative	18.92 (7.45, 40.71)	21.14 ± 7.95	0.241
Final follow-up	18.54 ± 7.73	21.14 ± 8.04	0.846
ΔPT	-1.56 (18.10-15.89)	-1.03 ± 6.22	0.673
P value (pre-final)	0.014^a	0.379
SS
Preoperative	26.32 ± 8.52	26.98 ± 8.16	0.754
Final follow-up	28.92 ± 9.92	29.39 ± 9.02	0.196
ΔSS	2.60 (-13.78, 30.10)	2.65 (-11.60, 30.63)	0.847
P value (pre-final)	0.008^a	0.098
PI-LL
Preoperative	10.99 ± 13.60	13.98 ± 13.46	0.385
Final follow-up	4.33 ± 11.87	8.99 ± 11.24	0.117
ΔPI-LL	-6.65 ± 10.19	-4.53 (-28.71, 29.39)	0.453
P value (pre-final)	0.001^a	0.001^a

The unit of Angle is ° and the unit of distance is mm.

^aP < 0.05.

LL: Lumbar lordosis; L4S: L4 slope; L5S: L5 slope; L5I: L5 incidence; LASD: L1 axis and S1 distance; PI: Pelvic incidence; PT: Pelvic tilt; SS: Sacral slope; PI-LL: PI-LL mismatch; MIDLF: Midline lumbar fusion; MIS-TLIF: Minimally invasive transforaminal lumbar interbody.

Table 3 Clinical outcomes of the midline lumbar fusion and minimally invasive transforaminal lumbar interbody fusion groups before and after surgery

	MIDLF (n = 34)	MIS-TLIF (n = 29)	P value
Back pain VAS score
Preoperative	6.00 (0.00-8.00)	6.00 (0.00-9.00)	0.788
3 mo postoperation	2.00 (0.00-5.00)	1.00 (0.00-4.00)	0.028^a
Final follow-up	1.00 (0.00-5.00)	1.00 (0.00-3.00)	0.928
Leg pain VAS score
Preoperative	7.00 (0.00-9.00)	8.00 (2.00-10.00)	0.039^a
3 mo postoperation	2.00 (0.00-3.00)	1.00 (0.00-3.00)	0.270
Final follow-up	1.00 (0.00-2.00)	0.00 (0.00-5.00)	0.107
ODI score
Preoperative	63.50 ± 13.33	66.86 ± 14.61	0.343
3 mo postoperation	23.47 ± 5.66	20.21 ± 6.83	0.042^a
Final follow-up	14.12 ± 6.10	13.28 ± 4.13	0.531

^aP < 0.05.

VAS: Visual analog scale; ODI: Oswestry disability index; MIDLF: Midline lumbar fusion; MIS-TLIF: Minimally invasive transforaminal lumbar interbody.

Citation: Wang YT, Li BX, Wang SJ, Li CD, Sun HL. Radiological and clinical outcomes of midline lumbar fusion on sagittal lumbar-pelvic parameters for degenerative lumbar diseases. World J Clin Cases 2022; 10(35): 12880-12889
URL: https://www.wjgnet.com/2307-8960/full/v10/i35/12880.htm
DOI: https://dx.doi.org/10.12998/wjcc.v10.i35.12880