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Segmental and global lordosis changes with two-level axial lumbar interbody fusion and posterior instrumentation

Miguel A Melgar, William D Tobler, Robert J Ernst, Thomas J Raley, Neel Anand, Larry E Miller and Richard J Nasca
International Journal of Spine Surgery January 2014, 8 10; DOI: https://doi.org/10.14444/1010

Article Figures & Data

Figures

  • Fig. 1
    Fig. 1

    Scatterplot demonstrating relationship between preoperative lordosis and postoperative lordosis change at L1-S1. The grey shaded area represents ±5° compared to pre-treatment values. Patients with lordosis change > 5° are represented in red.

  • Fig. 2
    Fig. 2

    Scatterplot demonstrating relationship between preoperative lordosis and postoperative lordosis change at L5-S1. The grey shaded area represents ±5° compared to pre-treatment values. Patients with lordosis change > 5° are represented in red.

  • Fig. 3
    Fig. 3

    Lateral standing radiograph showing a) lordosis of 24° at L4-S1 and 50° at L1-S1 at pre-treatment, and b) 24° L4-S1 and 52° L1-S1 lordosis 2 years after two-level axial lumbar interbody fusion.

  • Fig. 4
    Fig. 4

    a) Anteroposterior and b) lateral CT scan of 2-level AxiaLIF and posterior instrumentation demonstrating solid fusion at 2 years.

Tables

  • Table 1

    Baseline Patient Characteristics

    CharacteristicValue
    Age, yr51±11
    Female gender48%
    Back pain severity7.8±1.7
    Oswestry Disability Index (%)*60±15
    Primary diagnosis
     • Degenerative disc disease38
     • Spondylolisthesis10
     • Spinal stenosis4
     • Radiculopathy3
     • Revision surgery3
    Global (L1-S1) lordosis, °48±9
    Segmental (L4-S1) lordosis, °32±9

    • Values are mean ± SD or n (%).

    • ↵* Collected on 38 of 58 patients.

  • Table 2

    Relationship of Lordosis Change with 2-year Clinical Outcomes and Fusion Rates.

    CharacteristicL1-S1 Lordosis ChangeL4-S1 Lordosis Change
    >5° ↓ (n = 6)≤ 5° ∆ (n = 47)>5° ↑ (n = 5)>5° ↓ (n = 7)≤ 5° ∆ (n = 49)>5° ↑ (n = 2)
    Fusion rate (L4-L5)100%92%100%100%92%100%
    Fusion rate (L5-S1)100%96%100%100%96%100%
    Mean back pain improvement75%53%56%71%52%69%
    Mean ODI improvement*59%42%56%67%38%100%
    Good or excellent Odom's75%85%75%100%82%100%

    • * n = 38

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Segmental and global lordosis changes with two-level axial lumbar interbody fusion and posterior instrumentation
Miguel A Melgar, William D Tobler, Robert J Ernst, Thomas J Raley, Neel Anand, Larry E Miller, Richard J Nasca
International Journal of Spine Surgery Jan 2014, 8 10; DOI: 10.14444/1010
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