Warning: mkdir(): Permission denied in /home/virtual/lib/view_data.php on line 87 Warning: chmod() expects exactly 2 parameters, 3 given in /home/virtual/lib/view_data.php on line 88 Warning: fopen(/home/virtual/e-kjs/journal/upload/ip_log/ip_log_2024-12.txt): failed to open stream: No such file or directory in /home/virtual/lib/view_data.php on line 95 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 96
Neurospine > Volume 21(2); 2024 > Article |
|
|
Funding/Support
This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Author Contribution
Conceptualization: SCR, ZP, NJB, ALM, NL, LDDA, JAO, BDE, MHP; Data curation: SCR, ZP, NJB, SS, JR, AS, JCH; Formal analysis: SCR, NJB, SS, JR, JCH; Methodology: SCR, NJB, JCH, ALM, NL, LDDA, JAO, MHP; Project administration: LDDA, JAO, BDE, MHP; Visualization: SCR, ZP, NJB, ALM, NL, LDDA, JAO, BDE, MHP; Writing original draft: SCR, ZP, NJB, SS, JR, AS; Writing – review & editing: SCR, ZP, NJB, JR, JCH, ALM, NL, LDDA, JAO, BDE, MHP.
Study | Type | Method of FC measurement (Cobb angle) | Surgery type | Inclusion criteria | Exclusion criteria | Study sample size |
---|---|---|---|---|---|---|
Zhang et al. [16] 2021 | Single-institution retrospective | Angle between superior endplate of L4 and the line formed by the pedicles of S1 | PSIF of > 5 segments ending at L5–S1 with facetectomy and osteotomy (decompression and TLIF were performed if anterior support was needed or to relieve spinal stenosis) | 1. Primary spinal deformity correction | 1. Fusion levels < 5; 2. history of hip or knee arthroplasty; 3. absolute discrepancy of leg length > 20 mm | N = 101 |
2. Instrumented fusion via posterior-only approach | ||||||
Amara et al. [23] 2020 | Single-institution retrospective | The curve below the major curve of thoracolumbar or lumbar scoliosis. Inclusion criterion: Cobb angle between L3–S1 > 10° | PSIF with 1–3 interbody fusions (ALIF/LLIF/TLIF) at the FC | 1. FC > 10° | NR | N = 78 (1 level = 19; 2 levels = 36; 3 levels = 23) |
2. Low back or extremity pain ipsilateral to FC concavity | ||||||
3. Treatment of FC with interbody fusion | ||||||
4. Preop and postop long-standing radiographs | ||||||
5. > 1-year follow-up | ||||||
Amara et al. [20] 2019 | Single-institution retrospective | The curve below the major curve of a lumbar or thoracolumbar scoliosis measured via Cobb angle; only Cobb angle > 10° considered FC | PSIF of L4–S1 (FC) versus T10-pelvis (LT) versus T2–4 to pelvis (UT) | 1. FC from L4–S1 > 10° | 1. Previous lumbar fusion surgery | N = 99 (FC = 27; LT = 46, UT = 26) |
2. Radiculopathy ipsilateral to the concavity of FC | ||||||
3. Pre and postop radiography studies | ||||||
4. > 1-year follow-up | ||||||
Chou et al. [22] 2018 | Multicenter retrospective study | Coronal Cobb angle of fractional curve | PSIF vs. cMIS | 1. > 18 years of age | 1. Hybrid open posterior surgery with interbody fusion | N = 118 (open = 79; cMIS = 39) |
2. Minimum of 3 levels fused | ||||||
3. Minimum 2-year follow-up | ||||||
4. FC > 10° | ||||||
5. At least one of the following: SVA ≥ 5 cm, PT ≥ 20°, lumbar Cobb angle ≥ 20°, or a PI-LL ≥ 10° | ||||||
Brown et al. [17] 2004 | Single-institution retrospective | Angle between the line connecting the superior iliac alae and the line formed by the pedicles of l4 | PSIF to L5 | 1. Fusion extending above T12 | 1. Need for decompression at L5–S1 | N = 16 |
2. Pre-exisitng L5–S1 deformity (not including isolated degeneration at L5–S1) | ||||||
Yagi et al. [21] 2014 | Single-institution retrospective | Coronal Cobb method | Combined single-rod anterior fusion and short PSIF to sacrum (hybrid) versus long PSIF with anterior release (control) | 1. Thoracic and thoracolumbar/lumbar curves (> 80°) | 1. Osteoporosis | N = 66 (33 per group) |
2. Nonprogressive thoracic deformity (> 30° flexibility) | 2. Revision surgery | |||||
3. Fractional curve (with segmental instability, stenosis or facet arthrosis) or degenerative disc disease | ||||||
Manwaring et al. [24] 2014 | Single-institution retrospective | NR | Staged cMIS with versus without L5–S1 TLIF | 1. Treatment of ADS with at least 2-level MIS LLIF procedure | 1. Hybrid construct involving posterior osteotomies | N = 15 (TLIF = 11; control = NR) |
2. Delayed second stage procedure with MIS PLIF | ||||||
Pugely et al. [18] 2017 | Single-institution retrospective | Coronal Cobb method | No surgery performed | 1. Coronal Cobb angle > 30° | 1. Central stenosis | N = 48 (group B = 14°; group F = 16°; group S = 18°) |
2. > 40 years of age | 2. Lateral recess stenosis | |||||
3. Standing scoliosis radiographs | 3. Disk herniation | |||||
4. Preop CT spine | ||||||
Buell et al. [25] 2021 | Multicenter retrospective study | Coronal L4–S1 Cobb angle | L4–S1 TLIF vs. ALIF | Index operation that involved TLIF or ALIF at L4–5 and/or L5–S1. Minimum 2-year postoperative follow-up | Any patient with active infection, malignancy, diagnosis of scoliosis other than adult degenerative | N = 106 (TLIF = 47, ALIF = 59) |
Geddes et al. [26] 2021 | Single-institution retrospective | Coronal Cobb method | ALIF+PSF+S2AI screws versus PSF+S2AI screws for thoracolumbar fusion | 1. Posterior lumbar fusion to the pelvis using S2AI screws | 1. Patients who had posterior 3-column osteotomies | N = 59 (ALIF+PSF = 31, PSF alone = 28) |
2. Presence of fractional curve | 2. Those lacking adequate pre- and/or postoperative imaging | |||||
Hofler et al. [43] 2022 | Single-institution retrospective | Cobb angle method for lumbar fractional curve. The magnitude of the major lumbar coronal curve and fractional lumbar coronal curve caudal to it was measured on preoperative and follow-up anteroposterior imaging | T3-ilum fusion +/- kickstand placement | 1. Deformity correction with fusion from upper thoracic spine to pelvis | NR | N = 15 (kickstand = 7, nonkickstand = 8) |
2. Associated coronal deformity | ||||||
3. Intraoperative APLCRs performed | ||||||
Zuckerman et al. [27] 2023 | Single-institution retrospective | Cobb angle between the sacrum and most tilted lower lumbar vertebra (either L3/4/5) | Instrumentation to pelvis/fusion to sacrum and TLIF | 1. ≥ 6-level fusion | NR | N = 243 |
2. At least 1 of the following radiographic criteria (Cobb angle > 30˚, SVA > 5 cm, CVA > 3 cm, PT > 25˚, or TK > 60˚) |
PSIF, open posterior spinal instrument fusion; TLIF, transforaminal lumbar interbody fusion; ALIF, anterior lumbar interbody fusion; LLIF, lateral lumbar interbody fusion; FC, fractional curve; LT, lower thoracic; UT, upper thoracic; cMIS, circumferential minimally invasive surgery; SVA, sagittal vertical axis; PT, pelvic tilt; PI-LL, pelvic incidence-lumbar lordosis; NR, not reported; MIS, minimally invasive surgery; CT, computed tomography; PSF, posterior spinal fusion; S2AI, S2 alar iliac screw; APLCR, anteroposterior long cassette radiograph; CVA, coronal vertical axis; TK, thoracic kyphosis.
Study | Preoperative FC | Postoperative FC | FC correction | FC radiographic predictors | Conclusions |
---|---|---|---|---|---|
Zhang et al. [16] 2021 | 13.6° ± 8.2° | 5.9 ± 5.1° | p < 0.001 | Preoperative FC with L4 coronal tilt toward C7 plumbline is associated with postoperative coronal imbalance | Directionality of preoperative FC toward C7 plumbline increasing risk of postoperative coronal imbalance |
Amara et al. [23] 2020 | 1 Level = 15.3° ± 8.2°, 2 levels = 117.9°, 3 levels = 16.3° | 13.6° ± 8.2° | Group 1 vs. 2 = 0.0062; group 1 vs. 3 = 0.017; group 2 vs. 3 = 0.99 | None | Additional interbody fusion levels at the FC resulted in more fractional curve correction, more major curve correction, increasing lordosis without increasing morbidity |
Amara et al. [23] 2019 | FC = 15.7°, LT = 16.7°, UT = 16.9° | NR | NR | None | Treatment of only the FC was associated with lower complication rates, shorter hospital LOS and reduced blood loss than fusion to UT or LT levels; FC group had higher rates of re-extension UT or LT levels |
Chou et al. [23] 2018 | FC > 10° Matched cohort: preop FC–cMIS: 18 and open: 18 | Unmatched cohort: postop FC – cMIS: 17 and open: 19.6 | cMIS = 6.9°; Open = 8.5° | None | cMIS achieved similar reduction in leg pain and correction of fractional curve as traditional open surgery, despite significantly fewer cMIS patients undergoing direct decompression |
Brown et al. [17] 2004 | 21° | 10.6° | NR | Less postoperative FC decreased risk of L5–S1 degeneration | Patients with good postop FC achieved better outcomes with posterior fusion to L5, avoiding sacral fusion |
Yagi et al. [21] 2014 | Hybrid = 23° ± 9°, control = 24° ± 10° | Hybrid = 7 ± 4°, control = 15 ± 8° | Percent correction of lumbosacral curve significantly better in hybrid versus control (p < 0.001) | None | Hybrid patients had improved curve correction, fewer levels fused, decreased blood loss and fewer revision procedure when compared to control |
Manwaring et al. [24] 2014 | TLIF = 9.2°, control = NR | TLIF = 4.1°, control = NR | NA | None | Significant fractional curve correction in staged cMIS is achieved through 2 stage TLIF treatment of L5–S1 |
Pugely et al. [18] 2017 | Group B = 19.4°; group F = 25.5°; group S = 17.7° | NA | NA | None | Sciatic nerve pain in setting of lumbar structural curves is associated with foraminal stenosis at the concavity of the caudal fractional curve; femoral nerve pain likely caused by stenosis at concavity of main structural curve (L3 or below) |
Buell et al. [25] 2021 | All = 20.2° ± 7.0°, TLIF = 19.4° ± 7.2°, ALIF = 20.8° ± 6.9° | All = 6.9° ± 5.2°, TLIF = 7.1° ± 5.4°, ALIF = 6.8° ± 5.1° | Multiple regression demonstrated 1-mm increase in L4–5 TLIF cage height led to 2.2° reduction in L4 coronal tilt (p = 0.011), and 1° increase in L5–S1 ALIF cage lordosis led to 0.4° increase in L5–S1 segmental lordosis (p=0.045). Matched analysis demonstrated comparable fractional correction (TLIF = -13.6° ± 6.7° vs. ALIF = -13.6° ± 8.1°, p = 0.982). | None | Results demonstrate comparable fractional curve correction (66.7% for TLIF patients versus 64.8% for ALIF patients), despite the use of significantly larger and more lordotic cages in ALIF |
Geddes et al. [26] 2021 | PSF = 13.4° ± 7.1°, ALIF+PSF = 18.3 ± 9.3° | PSF = 8.6 ± 4.4°, ALIF+PSF = 6.1° ± 5.3° | PSF = 4.8 ± 4.5° (27% curve correction), ALIF+PSF = 12.1 ± 6.0° (68% correction), p = 0.053 | NR | ALIF+PSF achieves greater correction of the fractional curve than PSF alone. Though not the primary indication of ALIF, this may help facilitate overall deformity correction and pelvic balance |
Hofler et al. [43] 2022 | Kickstand = 4.3-cm coronal deviation, 43° major lumbar curve, 23° fractional lumbar curve | Kickstand group = 4.3-cm intraoperative coronal deviation, 1.8-cm postoperative coronal deviation | Preoperative lumbar FC was greater in patients requiring a kickstand (23° vs. 35°, p = 0.02) | NR | Intraoperative kickstand rod placement guided by intraoperative APLCR allows for satisfactory reduction in cases where the fractional coronal curve persists without loss of sagittal plane correction |
Nonkickstand = 2.2-cm coronal deviation, 35° major lumbar curve, 14° fractional lumbar curve | Nonkickstand group = 0.6-cm intraoperative coronal deviation, 2.1 cm postoperative coronal deviation | ||||
Zuckerman et al. [27] 2023 | Qiu type A=11.1° | Qiu type A=5.3° | Type C patients had the most LSF curve correction (p = 0.023 for change in LSF curve by 9.2°) | NR | Greater correction of LSF curve was seen in Qiu type C patients compared to type A and type B. More TLIFs were associated with greater amount of LSF curve correction. No clear trends seen regarding LSF curve change and postoperative outcomes |
Qiu type B=12.7° | Qiu type B=7.6° | ||||
Qiu type C=15.6° | Qiu type C=6.4° |
PSIF, open posterior spinal instrument fusion; TLIF, transforaminal lumbar interbody fusion; ALIF, anterior lumbar interbody fusion; LLIF, lateral lumbar interbody fusion; FC, fractional curve; LOS, length of stay; LT, lower thoracic; UT, upper thoracic; cMIS, circumferential minimally invasive surgery; NR, not reported; PSF, posterior spinal fusion; APLCR, anteroposterior long cassette radiograph.