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Research ArticleArticles

The Influence of Lordotic cages on creating Sagittal Balance in the CMIS treatment of Adult Spinal Deformity

Neel Anand, Ryan B. Cohen, Jason Cohen, Babak Kahndehroo, Sheila Kahwaty and Eli Baron
International Journal of Spine Surgery January 2017, 11 (3) 23; DOI: https://doi.org/10.14444/4023
Neel Anand
1Cedars Sinai Medical Center, Los Angeles, CA
MD
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Ryan B. Cohen
2Boston University School of Medicine, Boston, MA
BS
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Jason Cohen
3Albert Einstein College of Medicine, New York, NY
BS
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Babak Kahndehroo
1Cedars Sinai Medical Center, Los Angeles, CA
MD
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Sheila Kahwaty
1Cedars Sinai Medical Center, Los Angeles, CA
PA-C
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Eli Baron
1Cedars Sinai Medical Center, Los Angeles, CA
MD
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  • Article
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Article Figures & Data

Figures

  • Tables
  • Fig. 1
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    Fig. 1

    Preoperative sagittal image of lumbar spine before CMIS correction with hyperlordotic cages.

  • Fig. 2
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    Fig. 2

    Intraoperative fluoroscopy after placement of 12° cages at L3-4 and L4-5.

  • Fig. 3
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    Fig. 3

    Postoperative sagittal image of lumbar spine after 2-level cage placement. Segmental lordosis of 18° was achieved at L4-5.

  • Fig. 4
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    Fig. 4

    Preoperative XR imaging before placement of 12° cages for multilevel CMIS correction.

  • Fig. 5
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    Fig. 5

    Postoperative XR imaging after placement of 12° cages for multilevel CMIS correction.

Tables

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    Table 1

    Demographic information.

    Number of Patients66
    Mean Age66.08 (48-84)
    Total LLIF Levels224
    Mean Levels3.39
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    Table 2

    Total number of cages stratified by lordosis, position, and spinal level.

    LordosisCagesPositionCagesSpinal LevelCages
    6°58Anterior111T12-L114
    10°31Middle110L1-236
    12°130Middle3L2-356
    20°5L3-464
    L4-554
    Total224224224
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    Table 3

    Mean Segmental Lordosis and Global Lumbar Lordosis for Entire Cohort.

    PreoperativePostoperativeDeltaP value
    Mean Segmental Lordosis4.2312.177.95.000*
    Mean Lumbar Lordosis39.4349.3210.05.000*
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    Table 4

    Mean segmental lordosis grouped by lordotic angle of cage.

    Mean Segmental Lordosis
    LordosisPreoperativePostoperativeDeltaP value
    6°1.749.00 (4.09-20.26, SD 3.64)7.26.000*
    10°5.0013.09 (6.07-20.57, SD 3.12)8.08.000*
    12°5.1813.23 (4.79-25.38, SD 3.38)8.03.000*
    20°4.1018.23 (16.77-19.75, SD 1.28)14.22.000*
    ANOVA Postoperative between groups:.000*
    • View popup
    Table 5

    Mean segmental lordosis grouped by relative position of cage in disc space.

    Mean Segmental Lordosis
    PositionPreoperativePostoperativeDeltaP value
    Anterior4.6513.02 (4.79-25.38, SD 3.58)8.36.000*
    Middle3.8911.47 (4.09-19.75, SD 4.12)7.58.000*
    Posterior1.528.23 (5.96-11.43, SD 2.85)6.71.036*
    ANOVA Postoperative between groups:.000*
    • View popup
    Table 6

    Mean segmental lordosis grouped by spinal level of cage placement.

    Mean Segmental Lordosis
    LevelPreoperativePostoperativeDeltaP value
    T12-L1.988.43 (4.09-15.93, SD 2.92)7.44.000*
    L1-21.9110.02 (4.42-20.26, SD 3.99)8.12.000*
    L2-33.6711.38 (4.79-18.87, SD 3.74)7.71.000*
    L3-44.8212.91 (5.96-25.38, SD 3.60)8.08.000*
    L4-54.8214.58 (6.92-20.79, SD 2.98)8.05.000*
    ANOVA Postoperative between groups:.000*
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International Journal of Spine Surgery
Vol. 11, Issue 3
1 Jan 2017
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The Influence of Lordotic cages on creating Sagittal Balance in the CMIS treatment of Adult Spinal Deformity
Neel Anand, Ryan B. Cohen, Jason Cohen, Babak Kahndehroo, Sheila Kahwaty, Eli Baron
International Journal of Spine Surgery Jan 2017, 11 (3) 23; DOI: 10.14444/4023

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The Influence of Lordotic cages on creating Sagittal Balance in the CMIS treatment of Adult Spinal Deformity
Neel Anand, Ryan B. Cohen, Jason Cohen, Babak Kahndehroo, Sheila Kahwaty, Eli Baron
International Journal of Spine Surgery Jan 2017, 11 (3) 23; DOI: 10.14444/4023
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Keywords

  • cmis
  • minimally invasive
  • cages
  • lordotic
  • segmental lordosis
  • interbody fusion
  • hyperlordotic
  • adult spinal deformity

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