Segmental lordosis of PLIF for lumbar degenerative spondylolisthesis -Importance of dorsal compression between pedicle screws

• Published in: Journal of Spine Research Vol. 15; no. 10; pp. 1243 - 1248
• Main Authors: Kumahara, Ryotaro, Echigoya, Naoki, Ono, Atsushi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Spine Surgery and Related Research 20.10.2024; 一般社団法人 日本脊椎脊髄病学会
• Subjects: L4 degenerative spondylolisthesis; L4変性すべり症; Posterior Lumbar Interbody Fusion (PLIF); Segmental lordosis; 局所前弯角; 後方経路腰椎椎体間固定術
• ISSN: 1884-7137; 2435-1563
• DOI: 10.34371/jspineres.2024-1006

In PLIF for lumbar degenerative spondylolisthesis, we investigated how much local lordosis can be achieved by dorsal compression between the multi-axial pedicle screw (PS) heads. The subjects were 50 patients who underwent L4/5 PLIF for L4 degenerative spondylolisthesis. The average local lordotic angle between the L4/5 vertebrae was 2.6° in the preoperative neutral standing position, 5.1° in the intraoperative prone position, 6.0° after cage insertion, 10.2° after PS dorsal compression and 8.7° 6 months after surgery. The average local lordosis angle of 4.2° was obtained after PS dorsal compression.In PLIF for L4 degenerative spondylolisthesis, the local lordosis between L4/5 vertebrae increased at each stage: intraoperative prone position, after cage insertion, and PS dorsal compression. PS dorsal compression showed the greatest increase. Even when using a multi-axial PS head, dorsal compression between PS heads is useful for obtaining local lordosis.