Radiological Spino-pelvic Parameters In Lumbar Degenerative Disease After PLIF And TLIF

Objective: To observe the radiological spino-pelvic sagittal parameters in Lumbar degenerative disease after posterior lumbar interbody fusion and transforaminal lumbar interbody fusion for providing clinical basis for the surgery.Method: A total of 52 patients who underwent posterior accessed lumbar interbody fusion for Lumbar degenerative disease were enrolled. The patients were divided according to surgical type( posterior lumbar inter body fusion 23 cases vs.transforaminal lumbar interbody fusion 29 cases). We measured sacral slope, lumbar lordosis, Lordosis of all instrumented segments, Cranial adjacent segment lordosis,the L1 axis and SI distance, sacral inclination, sacral table angle, disc height in the STAR-PACS software. The change and variance in each parameter were analyzed with the paired t-test(p<0.05), pearson correlation analysis was used to analysis the correlation between parameters.Result: In PLIF group: CUSL was decreased from 6.74±4.62 to 5.25±4.80 with significantly statistical(P=0.033); CASL was decreased from 9.36±5.97 to 7.20±4.95,with significantly statistical( P=0.006); DH was increased from 0.38±0.10 to0.43±0.09 with significantly statistical(P<0.001)?In TLIF group SS was increased from31.55±9.24 to 34.58±7.50 with significantly statistical(P=0.041); CASL was decreased from 9.59±5.64 to 7.55±5.39 with significantly statistical(P<0.001);ISL was increased from 15.22±6.09 to 18.04±9.71 with significantly statistical( P=0.022) DH was increased from 0.38±0.10 to 0.43±0.09 with significantly statistical(P<0.001). There were significant correlations between ?SS and ?SI, ?SS and ?LL, ?SS and ?ISL, ?ISL and ?LL, ?LL and ?CASL in both groups. There were no significant correlations between ?SS and ?CUSL, ?SS and ?CASL.Conclusion: Both PLIF and TLIF could significant increase DH, but decrease CASL.CUSL was significant lower than preoperative in PLIF group. In TLIF group, CUSL did not significantly change. Because of the significant postoperative segment flat back,PLIF group may have more risk to cause adjacent segment degeneration. The clinical long-term outcomes need to be further prospectively analyzed.