title: Restoration of lordosis and disk height after single-level transforaminal lumbar interbody fusion.
abstract: OBJECTIVE
  To study radiographic and clinical outcomes after transforaminal lumbar interbody fusion (TLIF) in order to determine the impact of TLIF on lumbar lordosis, intervertebral height and improvement in clinical outcome measures.
  
  
  METHODS
  Forty-five patients who had undergone a single-level TLIF procedure for a single-level degenerative condition were retrospectively reviewed and their clinical histories, degree of pre- and post-operative lumbar lordosis, intervertebral height, and cage position recorded. Clinical assessment included use of modified Odom's criteria and a visual analog scale (VAS) for back and leg pain.
  
  
  RESULTS
  At 21 months, the patients had gained an average of 3.6° of lumbar lordosis and 4.5 mm disc height. Change in disc height was significantly associated with an anterior cage position while lumbar lordosis was unaffected by cage position. A spondylolisthesis subgroup demonstrated 31% reduction in the magnitude of anterior slip. Less lordosis was associated with worse back and leg pain as assessed by VAS and greater disk heights were associated with higher Odom's criteria scores. Patients with persistent leg pain at final follow-up had less lumbar lordosis and intervertebral height than patients without leg pain.
  
  
  CONCLUSIONS
  Intervertebral height and lumbar lordosis reconstruction are important for achieving good surgical results; guidance regarding the likely changes in lumbar lordosis and disk height after TLIF is provided by our findings.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University & Rothman Institute, Philadelphia, Pennsylvania 19107, USA. chris.kepler@gmail.com
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Kepler
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Rihn
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Radcliff
authors.forename: Amar A
authors.initials: AA
authors.lastname: Patel
authors.forename: D Greg
authors.initials: DG
authors.lastname: Anderson
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Vaccaro
authors.forename: Alan S
authors.initials: AS
authors.lastname: Hilibrand
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Albert
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome