| Objective: Study the characteristics and regularity of lumbar vertebral function curve classification after single segment transforaminal lumbar interbody fusion in patients with lumbar degenerative disease.Methods: Retrospective analysis of 560 patients with lumbar degeneration and acceptted TLIF surgery in our hospital from 2010 to 2015,according to the inclusion and exclusion criteria,121 cases who acceptted the lumbar vertebral single segment TLIF surgery and has the complete follow-up data were included in,there were 63 males and 58 females were included,the range of age was 20-62 years,and the mean age was 47.2 years.All patients underwent transforaminal lumbar interbody fusion(TLIF)surgery by the same surgeon..Based on the adjusting Roussouly lumbar spine classification method proposed by Weishi Li,the lumbar sagittal parameters were measured,which include the pelvic incidence(PI),sacral slope(SS),lumbar sacral angle(LL),thoracic lumbar kyphosis(TK),sagittal vertical axis(SVA).The clinical efficacy was assessed by VAS and JOA scores.In order to analysis the changes of lumbar vertebral function curve and the parameters of spine pelvic sagittal parameters at different time points before and after the surgery and their relationship.Results: The VAS and the JOA scores of all the patients were significantly improved after the surgery(P<0.05).When we measure the spino-pelvic parameters,we found that there were no significant differences in SS before and after the surgery(P>0.05),but there were significant differences in LL,TK,LSA,L1 SPI,T9spi and SVA before and after the surgery(P<0.05),among which the change of SVA was significantly,C7 PL was significantly backward shifted(P<0.05).According to the lumbar spine classification proposed by Weishi Li,there were 22 cases of type ?,28 cases of type ?,35 cases of type ? and 36 cases of type ? relatively.Among the patients,there were 64% of the patients whose lumbar spine classification were changed after the surgery,including 14 cases of type ?,15 cases of type ?,19 cases of type ? and 30 cases of type ? relatively.Analysis of the related factors of the changes of the lumbar lordosis,we found the correlation coeffcient between the changes of the intervertebral and the lumbar lordosis of the non-operative segment after the surgery is higher than the operative segment,there r value is 0.899 and 0.422 relatively(P<0.05).When we compared the cases whose lumbar function curve type did not have any change with the cases whose lumbar function curve type changed,we found except for that there was no statistically significant difference in PI value between the cases whose lumbar function curve type did not change in type ? group and those whose lumbar function curve type changed to type ?,There was a statistically significant difference in the PI values between the unchanged group and the changed group in the rest of the various type groups(P<0.05).When we re-grouped the patient according to the lumbar function curve after the surgery,we found that no matter what type of lumbar spine is before the surgery,there were no significant difference in the PI values in patients with the same lumbar function curve after the surgery(P> 0.05).Conclusions: Once the PI was in the same range,the type of the lumbar function curve of the patients are same.Once received single segment lumbar TLIF surgery,the lumbar degenerative disease patients' lumbar function curve and parameter changes were dominated by PI,that is to say,once the PI was in the same range the lumbar function curve classification will be restored to the same lumbar type matched to PI.This will help us use the PI values of the patient to predict the type of the lumbar curve and the formulation of the individualized surgical treatment programs suit for the patients. |
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