Radiographic Comparison of Lateral Lumbar Interbody Fusion Versus Traditional Fusion Approaches: Analysis of Sagittal Contour Change

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Fig. 1
Lateral standing radiograph of the lumbosacral spine showing measurements of lordosis evaluated in the study. Regional lordosis was measured using the superior endplate of L1 and S1. Segmental lordosis measurements were measured using the superior endplate of upper vertebra and the inferior endplate of lower vertebra, except at L5-S1 where the superior endplate of S1 was used.

Table 1

Summary of Diagnoses of the Different Fusion Techniques.

Table 2

Comparison of preoperative and postoperative lordosis within groups.

Table 3

Comparison of Preoperative and Postoperative Anterior Disk Height (ADH) and (Posterior Disk Height (PDH) within groups.

	Pre-op ADH [mean (mm) ± SD]	Post-op ADH [mean (mm) ± SD]	p value	Pre-op PDH [mean (mm) ± SD]	Post-op PDH [mean (mm) ± SD]	p value
LLIF	7.9 ± 4.3	13.8 ± 3.8	p<0.01	3.7 ± 2.5	6.5 ± 3.1	p<0.01
ALIF	9.7 ± 5.6	18.4 ± 5.1	p<0.01	3.8 ± 2.0	7.1 ± 2.6	p<0.01
TLIF	9.8 ± 5.1	12.6 ± 3.8	p<0.01	4.5 ± 3.0	5.9 ± 2.9	p<0.01
PSF	9.9 ± 4.2	10.2 ± 3.8	p=0.25	4.3 ± 2.1	3.9 ± 2.0	p=0.04

Table 4

Comparison of Superior (sup) and Inferior (inf) Level lordosis within groups.

	Pre-op sup lordosis (mean ± SD)	Post-op sup lordosis (mean ± SD)	p value	Pre-op inf lordosis (mean ± SD)	Post-op inf lordosis (mean ± SD)	p value
LLIF	9.1 ± 8.1°	8.7 ± 7.9°	p=0.27	22.2 ± 7.3°	22.2 ± 7.7°	p=0.99
ALIF	17.3 ± 10.1°	14.8 ± 9.5°	p<0.01	21.8 ± 8.5°	18.3 ± 8.2°	p=0.25
TLIF	12.6 ± 10.2°	12.1 ± 10.4°	p=0.07	15.1 ± 6.3°	15.1 ± 6.0°	p=0.99
PSF	11.7 ± 8.8°	12 ± 9.1°	p=0.54	18.7 ± 8.1°	18.0 ± 8.1°	p=0.20

Table 5

Comparison of Regional (L1-S1) Lordosis Change in Single Level Fusions

	Pre-op lordosis (mean ± SD)	Post-op lordosis (mean ± SD)	Mean Change	p value
LLIF (n=18)	54.6 ± 9.2°	56.4 ± 8.0°	1.8 ± 3.7°	p=0.05
ALIF (n=23)	54.8 ± 11.3°	57.2 ± 12.7°	2.4 ± 5.1°	p=0.03
TLIF (n=38)	49.3 ± 13.2°	50.1 ± 13.6°	1.4 ± 4.5°	p=0.06
PSF (n=18)	50.8 ± 16.1°	51.1 ± 17.6°	0.3 ± 6.9°	p=0.86

Table 6

Comparison of Regional (L1-S1) Lordosis Change in Multilevel (≥2 levels) Fusions.

	Pre-op lordosis (mean ± SD)	Post-op lordosis (mean ± SD)	Mean Change	p value
LLIF (n=17)	48.0 ± 12.7°	51.2 ± 11.5°	3.3 ± 4.5°	p=0.01
ALIF (n=13)	46.0 ± 14.3°	53.3 ± 12.6°	7.7 ± 5.9°	p<0.01
TLIF (n=12)	40.6 ± 15.9°	44.9 ± 16.7°	4.3 ± 9.3°	p=0.13
PSF (n=8)	46.5 ± 12.5°	44.1 ± 14.7°	-2.4 ± 3.9°	p=0.12

Table 7

Literature on Segmental Lordosis Change after LLIF.