个性化椎间融合术后骨盆发生率与腰椎后凸不匹配:脊柱退行性疾病术前规划和对位的重要性。

IF 1.7 Q2 SURGERY
Jahangir Asghar, Ashvin I Patel, Joseph A Osorio, Justin S Smith, John Small, Jeffrey P Mullin, Atman Desai, Michele Temple-Wong, Rodrigo J Nicolau
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引用次数: 0

摘要

背景:新出现的数据强调了在进行短节段融合术时,根据骨盆形态规划和调整全腰椎和节段腰椎前凸的重要性,目的是降低邻近节段疾病的风险,同时减少脊柱相关残疾。本研究评估了个性化椎体间植入物在恢复骨盆入射角-腰椎前凸(PI-LL)不匹配方面的影响,并与使用库存椎体间植入物的类似研究进行了比较:这项多中心回顾性分析评估了因退行性(非畸形)适应症而使用个性化椎体间植入物进行 1 级或 2 级腰椎融合术的患者术前和术后脊柱骨盆对位(PI-LL)的影像学情况。目的是评估融合手术前后对位不良(PI-LL ≥ 10°)的发生率,并确定该人群的对位保持率和/或矫正率:本研究共纳入 135 名患者。在 83 名术前对位的患者中,76 人(91.6%)的对位得到保留,7 人(8.4%)的对位恶化。在 52 名术前排列不齐的患者中,23 人(44.2%)的排列得到了恢复,29 人(55.8%)的排列未得到完全矫正。在术前对齐的患者中,库存器械和个性化椎间孔镜在 "保持 "或 "恶化 "组别中没有显著的统计学差异。相比之下,在术前错位的患者中,使用个性化椎间孔镜的 "恢复 "组与历史库存器械数据相比有统计学意义的增加(P = 0.046),而 "恶化 "组则有统计学意义的减少(P < 0.05):结论:与使用库存植入物的历史群组相比,短节段融合术中的个性化椎间植入物在使患者恢复正常 PI-LL 方面具有统计学意义上的显著改善。使用三维术前规划结合个性化植入物为规划和改善脊柱骨盆参数提供了重要工具:3:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mismatch Between Pelvic Incidence and Lumbar Lordosis After Personalized Interbody Fusion: The Importance of Preoperative Planning and Alignment in Degenerative Spine Diseases.

Background: Emerging data have highlighted the significance of planning and aligning total and segmental lumbar lordosis with pelvic morphology when performing short-segment fusion with the goal of reducing the risk of adjacent segment disease while also decreasing spine-related disability. This study evaluates the impact of personalized interbody implants in restoring pelvic incidence-lumbar lordosis (PI-LL) mismatch compared with a similar study using stock interbody implants.

Methods: This multicenter retrospective analysis assessed radiographic pre- and postoperative spinopelvic alignment (PI-LL) in patients who underwent 1- or 2-level lumbar fusions with personalized interbody implants for degenerative (nondeformity) indications. The aim was to assess the incidence of malalignment (PI-LL ≥ 10°) both before and after fusion surgery and to determine the rate of alignment preservation and/or correction in this population.

Results: There were 135 patients included in this study. Of 83 patients who were aligned preoperatively, alignment was preserved in 76 (91.6%) and worsened in 7 (8.4%). Among the 52 preoperatively malaligned patients, alignment was restored in 23 (44.2%), and 29 (55.8%) were not fully corrected. Among patients who were preoperatively aligned, there was no statistically significant difference in either the "preserved" or "worsened" groups between stock devices and personalized interbody devices. In contrast, among patients who were preoperatively malaligned, there was a statistically significant increase in the "restored" group (P = 0.046) and a statistically significant decrease in the "worsened" groups in patients with personalized interbodies compared with historical stock device data (P < 0.05).

Conclusions: Compared with a historical cohort with stock implants, personalized interbody implants in short-segment fusions have shown a statistically significant improvement in restoring patients to normative PI-LL. Using 3-dimensional preoperative planning combined with personalized implants provides an important tool for planning and achieving improvement in spinopelvic parameters.

Level of evidence: 3:

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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
162
期刊介绍: The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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