Functional outcome of surgical management of low mid-grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively: a prospective study
Abstract Background Prospective study objectives. A sagittal balance is a good tool to improve the functional outcome of spine spondylolisthesis surgeries, primarily noted that it has a good impact in deformity surgery and then applied to every spine surgery and the aim of this study is to evaluate...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-11-01
|
| Series: | Chinese Neurosurgical Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41016-022-00303-2 |
| _version_ | 1811304605235019776 |
|---|---|
| author | Sameh Elmorsy Hassan Elmorsy Hazem Abdelsattar Abulnasr Yousry Hassan Magdy Samra Ehab Mohamed Eissa |
| author_facet | Sameh Elmorsy Hassan Elmorsy Hazem Abdelsattar Abulnasr Yousry Hassan Magdy Samra Ehab Mohamed Eissa |
| author_sort | Sameh Elmorsy Hassan Elmorsy |
| collection | DOAJ |
| description | Abstract Background Prospective study objectives. A sagittal balance is a good tool to improve the functional outcome of spine spondylolisthesis surgeries, primarily noted that it has a good impact in deformity surgery and then applied to every spine surgery and the aim of this study is to evaluate its functional outcome when considered in preoperative planning for non-dysplastic low- and mid-grade spondylolisthesis surgeries. Method Forty patients diagnosed as low- or mid-grade non-dysplastic spondylolisthesis had undergone surgery at Cairo University after failed medical treatment had been evaluated preoperatively by measuring the sagittal balance parameters which include SVA, spinopelvic angles, lumbar lordosis, pelvic tilt, sacral slope, and pelvic incidence and then measure it along a follow-up period of 1 year postoperatively started from February 2018 and correlate it with functional outcome using Oswestry score (ODI)and VAS. Correction of parameters has been estimated preoperatively by manual estimation and Surgimap application then applied during the operation. Results All patients were treated by surgical treatment through posterior transpedicular screw fixation with conventional or reduction screws and fusion ± TLIF cages. The mean of lumbar lordosis and mean spinopelvic angles were increased in a statistically significant manner. Pelvis tilt was decreased in a statistically insignificant manner. The mean of pelvic incidence was not changed and statistically insignificant, and this is matching the fact that pelvic incidence is a constant parameter. The sacral slope was increased in a statistically insignificant manner. Final results showed that 37 had a statistically significant improvement in their ODI >20% at the last visit. Three patients had a poor clinical outcome with ODI scorFinal results showed that 37 had a statistically significant improvement in their ODI >20% at the last visit. Three patients had a poor clinical outcome with ODI score of >20% improvement, and we noticed that the level of pathology was at the level of L4L5, SVA was positive and worsen postoperatively, and also, it is accompanied by decreased lumbar lordosis. Change in ODI means statistically significant improvement when considering sagittal parameters preoperation and during operation. Conclusion Sagittal balance parameters should be considered in the surgical management of low-grade spondylolisthesis cases to improve their functional outcome. |
| first_indexed | 2024-04-13T08:10:25Z |
| format | Article |
| id | doaj.art-739d7693bd3147ae8dda0f9694ea4650 |
| institution | Directory Open Access Journal |
| issn | 2057-4967 |
| language | English |
| last_indexed | 2024-04-13T08:10:25Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Chinese Neurosurgical Journal |
| spelling | doaj.art-739d7693bd3147ae8dda0f9694ea46502022-12-22T02:55:00ZengBMCChinese Neurosurgical Journal2057-49672022-11-018111210.1186/s41016-022-00303-2Functional outcome of surgical management of low mid-grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively: a prospective studySameh Elmorsy Hassan Elmorsy0Hazem Abdelsattar Abulnasr1Yousry Hassan2Magdy Samra3Ehab Mohamed Eissa4Shiekh Zayed Al-nahian HospitalNeurosurgery Cairo UniversityNeurosurgery Cairo UniversityNeurosurgery Cairo UniversityNeurosurgery Cairo UniversityAbstract Background Prospective study objectives. A sagittal balance is a good tool to improve the functional outcome of spine spondylolisthesis surgeries, primarily noted that it has a good impact in deformity surgery and then applied to every spine surgery and the aim of this study is to evaluate its functional outcome when considered in preoperative planning for non-dysplastic low- and mid-grade spondylolisthesis surgeries. Method Forty patients diagnosed as low- or mid-grade non-dysplastic spondylolisthesis had undergone surgery at Cairo University after failed medical treatment had been evaluated preoperatively by measuring the sagittal balance parameters which include SVA, spinopelvic angles, lumbar lordosis, pelvic tilt, sacral slope, and pelvic incidence and then measure it along a follow-up period of 1 year postoperatively started from February 2018 and correlate it with functional outcome using Oswestry score (ODI)and VAS. Correction of parameters has been estimated preoperatively by manual estimation and Surgimap application then applied during the operation. Results All patients were treated by surgical treatment through posterior transpedicular screw fixation with conventional or reduction screws and fusion ± TLIF cages. The mean of lumbar lordosis and mean spinopelvic angles were increased in a statistically significant manner. Pelvis tilt was decreased in a statistically insignificant manner. The mean of pelvic incidence was not changed and statistically insignificant, and this is matching the fact that pelvic incidence is a constant parameter. The sacral slope was increased in a statistically insignificant manner. Final results showed that 37 had a statistically significant improvement in their ODI >20% at the last visit. Three patients had a poor clinical outcome with ODI scorFinal results showed that 37 had a statistically significant improvement in their ODI >20% at the last visit. Three patients had a poor clinical outcome with ODI score of >20% improvement, and we noticed that the level of pathology was at the level of L4L5, SVA was positive and worsen postoperatively, and also, it is accompanied by decreased lumbar lordosis. Change in ODI means statistically significant improvement when considering sagittal parameters preoperation and during operation. Conclusion Sagittal balance parameters should be considered in the surgical management of low-grade spondylolisthesis cases to improve their functional outcome.https://doi.org/10.1186/s41016-022-00303-2SpondylolisthesisLow-grade spondylolisthesisSagittal balanceLumbar lordosis |
| spellingShingle | Sameh Elmorsy Hassan Elmorsy Hazem Abdelsattar Abulnasr Yousry Hassan Magdy Samra Ehab Mohamed Eissa Functional outcome of surgical management of low mid-grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively: a prospective study Chinese Neurosurgical Journal Spondylolisthesis Low-grade spondylolisthesis Sagittal balance Lumbar lordosis |
| title | Functional outcome of surgical management of low mid-grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively: a prospective study |
| title_full | Functional outcome of surgical management of low mid-grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively: a prospective study |
| title_fullStr | Functional outcome of surgical management of low mid-grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively: a prospective study |
| title_full_unstemmed | Functional outcome of surgical management of low mid-grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively: a prospective study |
| title_short | Functional outcome of surgical management of low mid-grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively: a prospective study |
| title_sort | functional outcome of surgical management of low mid grade lumbar spondylolisthesis when considering the sagittal balance parameters preoperatively a prospective study |
| topic | Spondylolisthesis Low-grade spondylolisthesis Sagittal balance Lumbar lordosis |
| url | https://doi.org/10.1186/s41016-022-00303-2 |
| work_keys_str_mv | AT samehelmorsyhassanelmorsy functionaloutcomeofsurgicalmanagementoflowmidgradelumbarspondylolisthesiswhenconsideringthesagittalbalanceparameterspreoperativelyaprospectivestudy AT hazemabdelsattarabulnasr functionaloutcomeofsurgicalmanagementoflowmidgradelumbarspondylolisthesiswhenconsideringthesagittalbalanceparameterspreoperativelyaprospectivestudy AT yousryhassan functionaloutcomeofsurgicalmanagementoflowmidgradelumbarspondylolisthesiswhenconsideringthesagittalbalanceparameterspreoperativelyaprospectivestudy AT magdysamra functionaloutcomeofsurgicalmanagementoflowmidgradelumbarspondylolisthesiswhenconsideringthesagittalbalanceparameterspreoperativelyaprospectivestudy AT ehabmohamedeissa functionaloutcomeofsurgicalmanagementoflowmidgradelumbarspondylolisthesiswhenconsideringthesagittalbalanceparameterspreoperativelyaprospectivestudy |