title: Segmental lumbar sagittal correction after bilateral transforaminal lumbar interbody fusion.
abstract: OBJECTIVE
  In this paper the authors sought to determine the segmental lumbar sagittal contour change after bilateral transforaminal lumbar interbody fusion (TLIF).
  
  
  METHODS
  Between March 2007 and October 2010, 42 consecutive patients (57 levels) underwent bilateral TLIF. Standard preoperative and 6-week postoperative standing lumbar spine radiographs were examined. Preoperative and postoperative segmental lordosis was determined by manual measurements using the Cobb method. The difference between the preoperative and postoperative values were calculated and analyzed for statistical significance.
  
  
  RESULTS
  The mean preoperative segmental alignment was 8.1°. The mean postoperative alignment was 15.3°, with a mean correction of 7.2° per segment. The largest gain in lordosis was obtained at the L5-S1 level (10.1°). There was a significant difference between the preoperative and postoperative values (p = 5 × 10(-9)). There was no significant difference in mean segmental correction between levels. Improvement in lordosis was higher in multilevel fusions (9.8°) than in single-level fusions (5.2°) (p = 0.047). There was an inverse correlation between preoperative sagittal lordosis measurement and change in lordosis (r = -0.599).
  
  
  CONCLUSIONS
  A significant improvement in lumbar lordosis can be gained by preforming bilateral facetectomies in TLIF with posterior compression. This procedure provides an additional option to a spine surgeon's armamentarium in dealing with significant lumbar sagittal plane deformities.
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN 55454, USA. scyson@umn.edu
authors.forename: Sharon C
authors.initials: SC
authors.lastname: Yson
authors.forename: Edward Rainier G
authors.initials: ER
authors.lastname: Santos
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Sembrano
authors.forename: David W
authors.initials: DW
authors.lastname: Polly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000601:surgery*; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008141:Lordosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D012307:Risk Factors; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult