The Analysis And Study On The Changes Of Lumbar Function Curve After A Lumbar Surgery In Patients With Lumbar Degenerative Disease

Part 1:The Change of the Sagittal Alignment Function Curve after a Lumbar Surgery in Patients with Lumbar Degenerative Disease Objective:To study the change of the sagittal alignment function curve in patients with lumbar degenerative diseases after a lumbar surgery based on Roussouly classification.Methods:Retrospective analysis of 156 patients accepting a lumbar surgery due to lumbar degenerative diseases during the period from January 2014 to June 2017,according to the inclusion criteria and exclusion criteria.Measure the angle of sacral slope and record the apex position of lumbar lordosis in the standing full-length spine lateral X-ray radiographs.Classify patients' preoperative and postoperative Roussouly types.Analysis the characteristics of the Roussouly classification type changing before and after the surgery.Results:62 males and 94 females are included in the study.The mean age of patients in this study is 49.18±8.90 years,and the mean follow-up time is 6.56±5.40 months.The P values of differences in preoperative Roussouly types and of postoperative Roussouly types in gender,age and follow-up time are 0.14,0.74,0.78 and 0.76,0.25,0.49 respectively.The P value of differences in last follow-up type changing proportion among each preoperative Roussouly type groups is 0.87.Patients' preoperative Roussouly type would alter to any postoperative Roussouly types,except that no patients with Roussouly type 4 are classified to Roussouly type 1 after the surgery.Conclusion:Lumbar degenerative diseases patients' sagittal alignment function curve type would change after a lumbar surgery.The change is independent of individual's gender,age,follow-up time and preoperative Roussouly type.A patient could be classified as any Roussouly type after the surgery,no matter what the preoperative Roussouly type is.Part 2:The Change of the Sagittal Alignment Function Curve after a Posterior Lumbar fusion Surgery Objective:The study aimed to describe the change of lumbar function curve of the human spine after the posterior lumbar fusion surgery,and explore the influencing factors of postoperative lumbar function curve type,based on Roussouly classification.Methods:Retrospective analysis of 167 patients accepting a lumbar surgery due to lumbar degenerative diseases during the period from January 2014 to December 2017,according to the inclusion criteria and exclusion criteria.Preoperative and postoperative general data(gender,age,follow-up time,ODI score,VAS score,diagnose and surgical segment)were recorded,clinical parameters(SVA,TK,LL,SS,PT and PI)were measured using Surgimap software,and the Roussouly classification type was assessed.Analysis the characteristics and influence factors of the Roussouly classification type changing before and after the surgery.Results:This study included 86 male patients and 81 female patients with a mean age of 52.04±12.36 years,and the mean follow-up time being 11.47±6.86 months.The value of sagittal alignment parameters changes after the posterior lumbar fusion surgery(P<0.05),except the value of PI(P=0.59).Roussouly classification type changed after surgery.The preoperative Roussouly types and value of preoperative PI,SS and LL are significantly different in patients of 4 postoperative Roussouly types(P<0.05).Conclusion:The lumbar function curve would change after a posterior lumbar fusion surgery.This change is independent of gender,age,follow-up time and the number of surgical segment.The value of preoperative PI is essential to predict one's postoperative lumbar function curve type.