See the published version of this preprint at Journal of Orthopaedic Surgery and Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research article
Yan Wang
Chinese PLA General Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5422-9212
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: adjacent segment disease (ASD) is an acknowledged problem of posterior lumbar interbody fusion (PLIF). Many studies have been reported concerning the role of lordosis distribution index (LDI) in spinal biomechanics. However, few reports have been published about the impact of LDI on ASD following L4-S1 PLIF.
Methods:The study enrolled 200 subjects who underwent L4-S1 PLIF for degenerative spine disease from 2009 to 2014. The average follow-up term was 84 months. Several lower lumbar parameters were measured, including lower lumbar lordosis (LLL), lumbar lordosis (LL) ,pelvic incidence (PI) and LDI on the pre- and postoperative radiograph. Perioperative information, comorbidities and operative data were documented. Kaplan-Meier curves were plotted for the comparisons of ASD-free survival of 3 different types of postoperative LDI subgroups.
Results: The incidence of ASD was found to be 8.5%. LL and LLL increased by 3.96°(38.71° vs 42.67° , P＜0.001) and 3.60° (26.22° vs 28.82° , P＜0.001) after lower lumbar fusion surgery, respectively. Lordosis distribution index (LDI) increased by 0.03 (0.66 vs 0.69, P=0.004) postoperatively. A significant difference(P=0.001) was observed when comparing the incidence of ASD among postoperative LDI subgroups.The Kaplan-Meier curves showed a marked difference in ASD-free survival between low and moderate LDI subgroup (Log Rank test, P=0.0012) , high and moderate LDI subgroup (Log Rank test, P=0.0005)
Conclusion: Patients with abnormal postoperative LDI were statistically more likely to develop ASD than those who had normal postoperative LDI. Moreover, patients with low postoperative LDI were at greater risk for developing ASD than those with high postoperative LDI over time.
Keywords
Adjacent segment disease, posterior lumbar interbody fusion, lordosis distribution index, lower lumbar lordosis, lumbar lordosis
Figure 1
Figure 2
Figure 3
Figure 4
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Journal of Orthopaedic Surgery and Research.
Version 2
Posted 04 Mar, 2020
No community comments so far
Editorial decision: Accept
On 11 Mar, 2020
Editor assigned
On 03 Mar, 2020
Reviewers invited
Invitations sent on 03 Mar, 2020
Reviewer #1 agreed
On 03 Mar, 2020
Reviewer #2 agreed
On 03 Mar, 2020
Review #1 received
Received 03 Mar, 2020
Review #2 received
Received 03 Mar, 2020
Submission checks complete
On 02 Mar, 2020
Editor invited
On 02 Mar, 2020
No comments provided
Editorial decision: Major revision
On 17 Feb, 2020
Review #1 received
Received 16 Feb, 2020
Review #2 received
Received 01 Feb, 2020
Reviewer #2 agreed
On 31 Jan, 2020
Reviewer #1 agreed
On 28 Jan, 2020
Editor assigned
On 10 Jan, 2020
Reviewers invited
Invitations sent on 10 Jan, 2020
First submitted
On 09 Jan, 2020
Submission checks complete
On 09 Jan, 2020
Editor invited
On 09 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at Journal of Orthopaedic Surgery and Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yan Wang
Chinese PLA General Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5422-9212
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Journal of Orthopaedic Surgery and Research.
Version 2
Posted 04 Mar, 2020
No community comments so far
Editorial decision: Accept
On 11 Mar, 2020
Editor assigned
On 03 Mar, 2020
Reviewers invited
Invitations sent on 03 Mar, 2020
Reviewer #1 agreed
On 03 Mar, 2020
Reviewer #2 agreed
On 03 Mar, 2020
Review #1 received
Received 03 Mar, 2020
Review #2 received
Received 03 Mar, 2020
Submission checks complete
On 02 Mar, 2020
Editor invited
On 02 Mar, 2020
No comments provided
Editorial decision: Major revision
On 17 Feb, 2020
Review #1 received
Received 16 Feb, 2020
Review #2 received
Received 01 Feb, 2020
Reviewer #2 agreed
On 31 Jan, 2020
Reviewer #1 agreed
On 28 Jan, 2020
Editor assigned
On 10 Jan, 2020
Reviewers invited
Invitations sent on 10 Jan, 2020
First submitted
On 09 Jan, 2020
Submission checks complete
On 09 Jan, 2020
Editor invited
On 09 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedic Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Journal of Orthopaedic Surgery and Research.
Background: adjacent segment disease (ASD) is an acknowledged problem of posterior lumbar interbody fusion (PLIF). Many studies have been reported concerning the role of lordosis distribution index (LDI) in spinal biomechanics. However, few reports have been published about the impact of LDI on ASD following L4-S1 PLIF.
Methods:The study enrolled 200 subjects who underwent L4-S1 PLIF for degenerative spine disease from 2009 to 2014. The average follow-up term was 84 months. Several lower lumbar parameters were measured, including lower lumbar lordosis (LLL), lumbar lordosis (LL) ,pelvic incidence (PI) and LDI on the pre- and postoperative radiograph. Perioperative information, comorbidities and operative data were documented. Kaplan-Meier curves were plotted for the comparisons of ASD-free survival of 3 different types of postoperative LDI subgroups.
Results: The incidence of ASD was found to be 8.5%. LL and LLL increased by 3.96°(38.71° vs 42.67° , P＜0.001) and 3.60° (26.22° vs 28.82° , P＜0.001) after lower lumbar fusion surgery, respectively. Lordosis distribution index (LDI) increased by 0.03 (0.66 vs 0.69, P=0.004) postoperatively. A significant difference(P=0.001) was observed when comparing the incidence of ASD among postoperative LDI subgroups.The Kaplan-Meier curves showed a marked difference in ASD-free survival between low and moderate LDI subgroup (Log Rank test, P=0.0012) , high and moderate LDI subgroup (Log Rank test, P=0.0005)
Conclusion: Patients with abnormal postoperative LDI were statistically more likely to develop ASD than those who had normal postoperative LDI. Moreover, patients with low postoperative LDI were at greater risk for developing ASD than those with high postoperative LDI over time.
Figure 1
Figure 2
Figure 3
Figure 4
Loading...