@article {MARTIN681, author = {CHRISTOPHER T. MARTIN and SHUO NIU and EMILY WHICKER and LAURA WARD and S. TIM YOON}, title = {Radiographic Factors Affecting Lordosis Correction After Transforaminal Lumbar Interbody Fusion With Unilateral Facetectomy}, volume = {14}, number = {5}, pages = {681--686}, year = {2020}, doi = {10.14444/7099}, publisher = {International Journal of Spine Surgery}, abstract = {Background: The study design was a retrospective cohort study. The objective was to identify preoperative (preop) radiographic features that are associated with increased lordosis correction after transforaminal lumbar interbody fusion (TLIF).Methods: We retrospectively reviewed a single surgeon series of TLIF performed at L4{\textendash}5 since 2010. The surgical technique involved unilateral facetectomy and insertion of a banana-type cage. A total of 107 cases were available with plain radiographs, and 62 with a preop computed tomography (CT) scan. We compared segmental lordosis correction between the preop and 6-week postoperative radiographs. Patients were divided into groups of those with or without more than 5{\textdegree} lordosis correction. Radiographic features were then compared, and a multivariate analysis was performed.Results: The mean lordosis correction of the entire cohort was 2.5{\textdegree} (range = -9{\textdegree} to 16{\textdegree}). The percentage of patients with a vacuum disc on the preop CT (40\% vs 10\%, P = 0.01) was higher in the group with greater than 5{\textdegree} lordosis correction, whereas the mean preop segmental lordosis (14.3{\textdegree} vs 18.6{\textdegree}) and the preop segmental disc angle (6.4{\textdegree} vs 8.4{\textdegree}) were both lower (P \< 0.05 for each). The percentage of patients with a Meyerding grade of 2 or higher (28\% vs 16\%) trended higher but was not significant (P = 0.1). There was no significant difference in the mean body mass index, patient age, preop lumbar lordosis, or disc space height.Conclusions: Patients with a preop vacuum disc sign on CT scan or those with a more kyphotic disc space on preop radiographs were more likely to achieve lordosis correction. This information may be useful in preop planning.Level of Evidence: 4.Clinical Relevance: Unilateral TLIF is likely to be neutral or kyphogenic in patients with a segmental disc angle that is neutral or lordotic pre-operatively, but is likely to increase segmental lordosis in patients with a disc angle that is kyphotic pre-oepratively.}, issn = {2211-4599}, URL = {https://www.ijssurgery.com/content/14/5/681}, eprint = {https://www.ijssurgery.com/content/14/5/681.full.pdf}, journal = {International Journal of Spine Surgery} }