Investigating the Spinopelvic Sagittal Parameters in Patients with Lumbar Canal Stenosis after Laminectomy

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Neurosurgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Resident, Department of Neurosurgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Spinal canal stenosis is the most common degenerative disease of the lumbar spine. Sagittal imbalance in degenerative spinal diseases is associated with disability and reduced quality of life. In this study, we examined the effect of lumbar spine laminectomy on improvement in spinopelvic sagittal parameters.Methods: This prospective cohort study was conducted during 2016-2019 at Ghaem and Shahid Kamyab hospitals, Mashhad, Iran. Patients underwent spinal radiography before and after laminectomy, and their spinopelvic sagittal parameters were measured. Data were analyzed using SPSS considering P < 0.050 statistically significant.Findings: Overall, 46 patients were examined in this study. The mean age was 52.9 ±11.9 years, 29 patients (63%) were men, and 17 (37%) were women. 28 subjects (60.9%) underwent 3-level and 18 subjects (39.1%) underwent 4-level laminectomy. Only the lumbar lordosis and sagittal vertical axis (SVA) were significantly changed after the surgery (P < 0.050).Conclusion: Lumbar canal stenosis disrupted the sagittal and global spinal balance. Multi-level laminectomy improved lumbar lordosis and SVA in lumbar canal stenosis.

Keywords

References

  1. Mac-Thiong JM, Labelle H, Roussouly P. Pediatric sagittal alignment. Eur Spine J 2011; 20)Suppl 5): 586-90.
  2. Grotle M, Smastuen M, Fjeld O, Grovle L, Helgeland J, Storheim K, et al. Lumbar spine surgery across 15 years: Trends, complications and reoperations in a longitudinal observational study from Norway. BMJ Open 2019; 9(8): e028743.
  3. Schwab F, Dubey A, Gamez L, El Fegoun AB, Hwang K, Pagala M, et al. Adult scoliosis: Prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976) 2005; 30(9): 1082-5.
  4. Jacob CJ, Cardoso IM, Batista JL, Maia TC, Roncaglio B. Spinopelvic parameters evaluation in a Brazilian population sample. Eur J Orthop Surg Traumatol 2015; 25(Suppl 1): S21-S24.
  5. Yukawa Y, Kato F, Suda K, Yamagata M, Ueta T, Yoshida M. Normative data for parameters of sagittal spinal alignment in healthy subjects: An analysis of gender specific differences and changes with aging in 626 asymptomatic individuals. Eur Spine J 2018; 27(2): 426-32.
  6. Chung NS, Jeon CH, Lee HD, Won SH. Measurement of spinopelvic parameters on standing lateral lumbar radiographs: Validity and reliability. Clin Spine Surg 2017; 30(2): E119-E123.
  7. Henneman SA, Antoneli PHL, de Oliveira GC. Pelvic incidence: A fundamental parameter for defining the sagittal balance of the spine. Coluna/Columna 2012; 11(3): 237-9.
  8. Li WS, Li G, Chen ZQ, Wood KB. Sagittal plane analysis of the spine and pelvis in adult idiopathic scoliosis. Chin Med J (Engl) 2010; 123(21): 2978-82.
  9. Kim CH, Chung CK, Park CS, Choi B, Hahn S, Kim MJ, et al. Reoperation rate after surgery for lumbar spinal stenosis without spondylolisthesis: A nationwide cohort study. Spine J 2013; 13(10): 1230-7.
  10. Takahashi K, Miyazaki T, Takino T, Matsui T, Tomita K. Epidural pressure measurements. Relationship between epidural pressure and posture in patients with lumbar spinal stenosis. Spine (Phila Pa 1976) 1995; 20(6): 650-3.
  11. Drummond Filho ML, Risso Neto MI, Lechoczi MA, Cavali PTM, Veiga IG, Zuiani GR, et al. Evaluation of spino-pelvic parameters according to intraoperative position in lumbosacral spine arthrodesis. Coluna/Columna 2013; 12(3): 228-31.
  12. Farrokhi MR, Haghnegahdar A, Rezaee H, Sharifi Rad MR. Spinal sagittal balance and spinopelvic parameters in patients with degenerative lumbar spinal stenosis; a comparative study. Clin Neurol Neurosurg 2016; 151: 136-41.
  13. Gussous Y, Theologis AA, Demb JB, Tangtiphaiboontana J, Berven S. Correlation between lumbopelvic and sagittal parameters and health-related quality of life in adults with lumbosacral spondylolisthesis. Global Spine J 2018; 8(1): 17-24.
  14. Suzuki H, Endo K, Kobayashi H, Tanaka H, Yamamoto K. Total sagittal spinal alignment in patients with lumbar canal stenosis accompanied by intermittent claudication. Spine (Phila Pa 1976) 2010; 35(9): E344-E346.
  15. Ogura Y, Shinozaki Y, Kobayashi Y, Kitagawa T, Yonezawa Y, Takahashi Y, et al. Impact of decompression surgery without fusion for lumbar spinal stenosis on sagittal spinopelvic alignment: Minimum 2-year follow-up. J Neurosurg Spine 2019; 30(6): 743-9.
  16. Fujii K, Kawamura N, Ikegami M, Niitsuma G, Kunogi J. Radiological improvements in global sagittal alignment after lumbar decompression without fusion. Spine (Phila Pa 1976) 2015; 40(10): 703-9.
Journal of Isfahan Medical School
Volume 38, Issue 604 - Serial Number 604
November and December 2021
Pages 936-940

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History

  • Receive Date: 07 September 2020
  • Revise Date:
  • Accept Date: 06 April 2022

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