34. miss - tlif治疗腰椎滑脱术后骨盆指数的变化：回顾性分析

IF 2.5 Q3 Medicine

North American Spine Society Journal Pub Date : 2025-07-01 DOI:10.1016/j.xnsj.2025.100728

Shrey Binyala MS, DNB

{"title":"34. miss - tlif治疗腰椎滑脱术后骨盆指数的变化：回顾性分析","authors":"Shrey Binyala MS, DNB","doi":"10.1016/j.xnsj.2025.100728","DOIUrl":null,"url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Lumbar spondylolisthesis often results in pelvic imbalance, contributing to chronic pain and disability. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has emerged as an effective surgical option, offering stabilization and correction of spinal alignment with reduced tissue disruption.</div></div><div><h3>PURPOSE</h3><div>This retrospective study evaluates postoperative improvements in pelvic indices, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL), in patients with lumbar spondylolisthesis treated with MIS-TLIF.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>The study design is retrospective. It involves reviewing and analyzing the medical records and radiographic data of patients who underwent MIS-TLIF for lumbar spondylolisthesis between 2018 and 2024. The study examines preoperative and postoperative changes in pelvic indices and their correlation with clinical outcomes.</div></div><div><h3>PATIENT SAMPLE</h3><div>A total of 354 patients were included in this retrospective study.</div></div><div><h3>OUTCOME MEASURES</h3><div>Pelvic Indices: PI, PT, SS, LL. Preoperative and postoperative changes in these parameters were assessed through radiographic imaging. Clinical Outcomes: pain levels, assessed using a visual analog scale (VAS) preoperatively and postoperatively. Functional improvements, measured using the Oswestry Disability Index (ODI) or a similar functional assessment tool. Sagittal Alignment: improvement in overall spinal sagittal balance, evaluated through radiographic measurements and clinical examination. Correlation between radiographic and clinical outcomes: The relationship between improvements in pelvic indices and clinical improvements in pain and function was analyzed. Complications: any intraoperative or postoperative complications, such as infection or hardware failure, were documented.</div></div><div><h3>METHODS</h3><div>This is a retrospective study involving patients who underwent MIS-TLIF for lumbar spondylolisthesis between 2018 and 2024. The following steps were involved: Patient Selection: inclusion criteria: patients diagnosed with lumbar spondylolisthesis who underwent MIS-TLIF surgery. Exclusion criteria: patients with incomplete clinical or radiographic data or those who had additional spine surgeries outside the MIS-TLIF approach. Radiographic Analysis: Preoperative and postoperative radiographs (x-rays or CT scans) were reviewed to measure key pelvic parameters, including: PI, PT, SS, LL. Changes in these pelvic indices were analyzed to evaluate improvements in sagittal alignment. Clinical Outcome Assessment: Pain Assessment: pain levels were measured using the VAS preoperatively and at follow-up intervals. Functional Outcome: Functional improvements were assessed using the ODI or other relevant clinical scoring tools. Follow-up: Patients were followed up at regular intervals (eg, 1, 3, and 6 months; 1, 2, and 4 years) to assess clinical and radiographic outcomes. Statistical Analysis: Descriptive statistics were used to summarize patient demographics, radiographic data, and clinical outcomes. Paired t-tests or other appropriate statistical tests were used to compare preoperative and postoperative pelvic indices and clinical scores. The correlation between radiographic improvements and clinical outcomes (pain relief and functional improvement) was evaluated. Complications: Any surgical complications, including hardware failure, infection, or neurological injury, were documented and analyzed.</div></div><div><h3>RESULTS</h3><div>Significant postoperative improvements were observed in PT and SS, contributing to better overall sagittal balance. PI improved significantly in patients with high grade spondylolisthesis. Patients reported reduced pain and improved functional outcomes postoperatively.</div></div><div><h3>CONCLUSIONS</h3><div>MIS-TLIF effectively restores pelvic parameters and improves sagittal alignment in lumbar spondylolisthesis patients. The correction of pelvic indices correlates with enhanced clinical outcomes, supporting MIS-TLIF as a reliable surgical approach for managing this condition.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100728"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"34. Postoperative changes in pelvic indices after MIS-TLIF for lumbar spondylolisthesis: retrospective analysis\",\"authors\":\"Shrey Binyala MS, DNB\",\"doi\":\"10.1016/j.xnsj.2025.100728\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>BACKGROUND CONTEXT</h3><div>Lumbar spondylolisthesis often results in pelvic imbalance, contributing to chronic pain and disability. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has emerged as an effective surgical option, offering stabilization and correction of spinal alignment with reduced tissue disruption.</div></div><div><h3>PURPOSE</h3><div>This retrospective study evaluates postoperative improvements in pelvic indices, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL), in patients with lumbar spondylolisthesis treated with MIS-TLIF.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>The study design is retrospective. It involves reviewing and analyzing the medical records and radiographic data of patients who underwent MIS-TLIF for lumbar spondylolisthesis between 2018 and 2024. The study examines preoperative and postoperative changes in pelvic indices and their correlation with clinical outcomes.</div></div><div><h3>PATIENT SAMPLE</h3><div>A total of 354 patients were included in this retrospective study.</div></div><div><h3>OUTCOME MEASURES</h3><div>Pelvic Indices: PI, PT, SS, LL. Preoperative and postoperative changes in these parameters were assessed through radiographic imaging. Clinical Outcomes: pain levels, assessed using a visual analog scale (VAS) preoperatively and postoperatively. Functional improvements, measured using the Oswestry Disability Index (ODI) or a similar functional assessment tool. Sagittal Alignment: improvement in overall spinal sagittal balance, evaluated through radiographic measurements and clinical examination. Correlation between radiographic and clinical outcomes: The relationship between improvements in pelvic indices and clinical improvements in pain and function was analyzed. Complications: any intraoperative or postoperative complications, such as infection or hardware failure, were documented.</div></div><div><h3>METHODS</h3><div>This is a retrospective study involving patients who underwent MIS-TLIF for lumbar spondylolisthesis between 2018 and 2024. The following steps were involved: Patient Selection: inclusion criteria: patients diagnosed with lumbar spondylolisthesis who underwent MIS-TLIF surgery. Exclusion criteria: patients with incomplete clinical or radiographic data or those who had additional spine surgeries outside the MIS-TLIF approach. Radiographic Analysis: Preoperative and postoperative radiographs (x-rays or CT scans) were reviewed to measure key pelvic parameters, including: PI, PT, SS, LL. Changes in these pelvic indices were analyzed to evaluate improvements in sagittal alignment. Clinical Outcome Assessment: Pain Assessment: pain levels were measured using the VAS preoperatively and at follow-up intervals. Functional Outcome: Functional improvements were assessed using the ODI or other relevant clinical scoring tools. Follow-up: Patients were followed up at regular intervals (eg, 1, 3, and 6 months; 1, 2, and 4 years) to assess clinical and radiographic outcomes. Statistical Analysis: Descriptive statistics were used to summarize patient demographics, radiographic data, and clinical outcomes. Paired t-tests or other appropriate statistical tests were used to compare preoperative and postoperative pelvic indices and clinical scores. The correlation between radiographic improvements and clinical outcomes (pain relief and functional improvement) was evaluated. Complications: Any surgical complications, including hardware failure, infection, or neurological injury, were documented and analyzed.</div></div><div><h3>RESULTS</h3><div>Significant postoperative improvements were observed in PT and SS, contributing to better overall sagittal balance. PI improved significantly in patients with high grade spondylolisthesis. Patients reported reduced pain and improved functional outcomes postoperatively.</div></div><div><h3>CONCLUSIONS</h3><div>MIS-TLIF effectively restores pelvic parameters and improves sagittal alignment in lumbar spondylolisthesis patients. The correction of pelvic indices correlates with enhanced clinical outcomes, supporting MIS-TLIF as a reliable surgical approach for managing this condition.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>\",\"PeriodicalId\":34622,\"journal\":{\"name\":\"North American Spine Society Journal\",\"volume\":\"22 \",\"pages\":\"Article 100728\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"North American Spine Society Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666548425001489\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"North American Spine Society Journal","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666548425001489","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

背景：腰椎滑脱常导致骨盆失衡，导致慢性疼痛和残疾。微创经椎间孔腰椎椎体间融合术（MIS-TLIF）已成为一种有效的手术选择，在减少组织破坏的同时稳定和矫正脊柱排列。目的：本回顾性研究评估经MIS-TLIF治疗的腰椎滑脱患者术后骨盆指数的改善，包括骨盆发生率（PI）、骨盆倾斜（PT）、骶骨斜度（SS）和腰椎前凸（LL）。研究设计/设置本研究采用回顾性设计。它涉及审查和分析2018年至2024年间因腰椎滑脱而接受MIS-TLIF的患者的医疗记录和放射学数据。该研究检查了术前和术后盆腔指数的变化及其与临床结果的相关性。本回顾性研究共纳入354例患者。主要指标：PI、PT、SS、LL。术前和术后这些参数的变化通过x线影像进行评估。临床结果：术前和术后用视觉模拟量表（VAS）评估疼痛水平。功能改善，使用Oswestry残疾指数（ODI）或类似的功能评估工具来衡量。矢状位对齐：通过x线测量和临床检查评估脊柱整体矢状位平衡的改善。影像学与临床结果的相关性：分析盆腔指数改善与临床疼痛和功能改善之间的关系。并发症：任何术中或术后并发症，如感染或硬件故障，记录在案。方法本研究是一项回顾性研究，涉及2018年至2024年腰椎滑脱患者。涉及以下步骤：患者选择：纳入标准：诊断为腰椎滑脱并接受MIS-TLIF手术的患者。排除标准：临床或影像学资料不完整的患者或在MIS-TLIF入路之外进行过额外脊柱手术的患者。影像学分析：回顾术前和术后x线片（x线或CT扫描）测量骨盆关键参数，包括：PI， PT， SS， LL。分析这些骨盆指数的变化，以评估矢状位对齐的改善。临床结果评估：疼痛评估：术前和随访期间采用VAS测量疼痛水平。功能结果：使用ODI或其他相关临床评分工具评估功能改善。随访：患者定期随访(如1、3、6个月；1、2和4年)评估临床和影像学结果。统计分析：描述性统计用于总结患者人口统计学、放射学资料和临床结果。采用配对t检验或其他适当的统计检验比较术前和术后盆腔指数和临床评分。评估影像学改善与临床结果（疼痛缓解和功能改善）之间的相关性。并发症：记录并分析任何手术并发症，包括硬件故障、感染或神经损伤。结果术后PT和SS均有明显改善，整体矢状面平衡改善。高度椎体滑脱患者的PI显著改善。患者报告术后疼痛减轻，功能改善。结论smis - tlif可有效恢复腰椎滑脱患者的骨盆参数并改善矢状位。骨盆指数的矫正与增强的临床结果相关，支持MIS-TLIF作为治疗这种疾病的可靠手术方法。FDA器械/药物状态本摘要不讨论或包括任何适用的器械或药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

34. Postoperative changes in pelvic indices after MIS-TLIF for lumbar spondylolisthesis: retrospective analysis

BACKGROUND CONTEXT

Lumbar spondylolisthesis often results in pelvic imbalance, contributing to chronic pain and disability. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has emerged as an effective surgical option, offering stabilization and correction of spinal alignment with reduced tissue disruption.

PURPOSE

This retrospective study evaluates postoperative improvements in pelvic indices, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL), in patients with lumbar spondylolisthesis treated with MIS-TLIF.

STUDY DESIGN/SETTING

The study design is retrospective. It involves reviewing and analyzing the medical records and radiographic data of patients who underwent MIS-TLIF for lumbar spondylolisthesis between 2018 and 2024. The study examines preoperative and postoperative changes in pelvic indices and their correlation with clinical outcomes.

PATIENT SAMPLE

A total of 354 patients were included in this retrospective study.

OUTCOME MEASURES

Pelvic Indices: PI, PT, SS, LL. Preoperative and postoperative changes in these parameters were assessed through radiographic imaging. Clinical Outcomes: pain levels, assessed using a visual analog scale (VAS) preoperatively and postoperatively. Functional improvements, measured using the Oswestry Disability Index (ODI) or a similar functional assessment tool. Sagittal Alignment: improvement in overall spinal sagittal balance, evaluated through radiographic measurements and clinical examination. Correlation between radiographic and clinical outcomes: The relationship between improvements in pelvic indices and clinical improvements in pain and function was analyzed. Complications: any intraoperative or postoperative complications, such as infection or hardware failure, were documented.

METHODS

This is a retrospective study involving patients who underwent MIS-TLIF for lumbar spondylolisthesis between 2018 and 2024. The following steps were involved: Patient Selection: inclusion criteria: patients diagnosed with lumbar spondylolisthesis who underwent MIS-TLIF surgery. Exclusion criteria: patients with incomplete clinical or radiographic data or those who had additional spine surgeries outside the MIS-TLIF approach. Radiographic Analysis: Preoperative and postoperative radiographs (x-rays or CT scans) were reviewed to measure key pelvic parameters, including: PI, PT, SS, LL. Changes in these pelvic indices were analyzed to evaluate improvements in sagittal alignment. Clinical Outcome Assessment: Pain Assessment: pain levels were measured using the VAS preoperatively and at follow-up intervals. Functional Outcome: Functional improvements were assessed using the ODI or other relevant clinical scoring tools. Follow-up: Patients were followed up at regular intervals (eg, 1, 3, and 6 months; 1, 2, and 4 years) to assess clinical and radiographic outcomes. Statistical Analysis: Descriptive statistics were used to summarize patient demographics, radiographic data, and clinical outcomes. Paired t-tests or other appropriate statistical tests were used to compare preoperative and postoperative pelvic indices and clinical scores. The correlation between radiographic improvements and clinical outcomes (pain relief and functional improvement) was evaluated. Complications: Any surgical complications, including hardware failure, infection, or neurological injury, were documented and analyzed.

RESULTS

Significant postoperative improvements were observed in PT and SS, contributing to better overall sagittal balance. PI improved significantly in patients with high grade spondylolisthesis. Patients reported reduced pain and improved functional outcomes postoperatively.

CONCLUSIONS

MIS-TLIF effectively restores pelvic parameters and improves sagittal alignment in lumbar spondylolisthesis patients. The correction of pelvic indices correlates with enhanced clinical outcomes, supporting MIS-TLIF as a reliable surgical approach for managing this condition.