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Sagittal Balance Not Improved With Anterior Lumbar Support

Last Updated: February 11, 2011.

Sagittal spinal balance outcomes do not appear to differ among patients who undergo anterior lumbar interbody fusion with posterolateral lumbar fusion (PLF) or PLF alone, and lumbar lordosis and type of lordosis correlate with outcomes, according to a study published in the Feb. 1 issue of Spine.

FRIDAY, Feb. 11 (HealthDay News) -- Sagittal spinal balance outcomes do not appear to differ among patients who undergo anterior lumbar interbody fusion (ALIF) with posterolateral lumbar fusion (PLF) or PLF alone, and lumbar lordosis and type of lordosis correlate with outcomes, according to a study published in the Feb. 1 issue of Spine.

Tina S. Videbaek, M.D., of the Aarhus University Hospital in Denmark, and colleagues randomly selected 148 patients with severe chronic low back pain for PLF + ALIF or PLF alone between 1996 and 1999, and 92 patients participated. The type of lumbar lordosis was evaluated, and outcome was assessed by Oswestry Disability Index (ODI).

The investigators found that sagittal balance parameters were similar between those who underwent PLF alone and those who underwent PLF + ALIF. The investigators also found that none of the sagittal balance parameters differed significantly among patients with an ODI of zero to 40 and those with an ODI over 40. Compared to unbalanced patients, balanced patients had a significantly superior outcome as measured by ODI. The authors noted that lumbar lordosis and type of lordosis correlated with outcome.

"No difference in the investigated sagittal balance parameters was seen between patients treated with PLF + ALIF or posterolateral fusion alone," the authors write. "Lumbar lordosis and type of lordosis correlated with outcome but could not explain the superior outcome in the group with anterior support. Whether sagittal balance and anterior support during fusion provide a protective effect on adjacent motion segments remains unclear."

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