A new study published in Spine examines the risk factors associated with transforaminal interbody fusion for lumbar degenerative disc disease.
The study authors examined 263 patients who underwent surgery; 150 patients underwent floating fusion and 113 patients underwent lumbosacral fusion. The patients underwent surgery from 2009 to 2012 and had an average of 37.6 month follow-ups. The researchers found:
1. Almost half — 43.3 percent — of the patients in both groups reported adjacent segment disease.
2. The patients reported lumbar lordosis improving by 7.5 degrees in the floating fusion group and 3.9 degrees in the lumbosacral fusion group after surgery. In the lumbosacral fusion group, the pelvic tilt worsened after surgery by 6.4 degrees.
3. There was a significant difference in the preoperative pelvic tilt in all patients when comparing the patients who eventually reported adjacent segment disease and those that didn't.
4. The patients with preoperative pelvic tilt more than 22.5 degrees were more likely to report adjacent segment disease after surgery.
5. The researchers concluded, "Patients with preoperative sagittal imbalance have a statistically significant increased risk of ASD." The risk was 5.1 times greater for patients with a preoperative pelvic tilt of more than 22.5 degrees.