Sagittal Alignment as Predictor of Adjacent Segment Disease After Lumbar Transforaminal Interbody Fusion.

Abstract

This study was carried out to explore the diagnostic value of sagittal measurements for adjacent segment disease after lumbar transforaminal interbody fusion (TLIF). A total of 163 subjects who underwent TLIF for lumbar disease were initially enrolled in the study from July 2013 to August 2017. Sagittal alignment including thoracic inlet and spinopelvic parameters was measured by using preoperative full-length freestanding radiographs. Multivariate logistic regression analysis was performed to evaluate these parameters as the diagnostic index for adjacent segment disease (ASD). A total of 153 patients completed the final follow-up, and the mean follow-up period was 40.6 months. There were 53 (35.3%) cases with ASD found after the TLIF in the enrolled subjects. Logistic regression analysis and receiver operating characteristic analysis confirmed that preoperative pelvic tilt (PT) of more than 24.1° and thoracic kyphosis (TK) of more than 23.3° were significant risk factors of ASD after TLIF (P < 0.05). We confirmed that PT of more than 24.3° and TK of more than 23.3° could be regarded as predictors of ASD after lumbar TLIF.