title: Correction of sagittal plane deformity and predictive factors for a favourable radiological outcome following multilevel posterior lumbar interbody fusion for mild degenerative scoliosis.
abstract: Limited data is available in the literature on the radiographic results of multilevel posterior lumbar interbody fusion (MPLIF) in the treatment of degenerative scoliosis. The objective of our study was to evaluate the segmental and global correction achieved with MPLIF in the treatment of degenerative scoliosis.
  
  
  
  Between 2009 and 2014, 42 patients underwent correction of degenerative scoliosis with MPLIF. Several radiological parameters were measured pre- and post-operatively by two independent observers. A statistical analysis was performed to assess the inter-observer reliability of the measurements and to determine the degree of segmental correction achieved at each intervertebral disc. Using sagittal vertical axis (SVA) less than 47 mm; lumbar lordosis (LL) within 11° of pelvic incidence (PI); and pelvic tilt (PT) no more than 22° as radiological criteria for procedural acceptability, we determined predictive factors for a favourable radiological outcome.
  
  
  
  Forty-two patients (34 female) were included in our study. The average amount of correction per segment was 6.2°. The overall correction achieved with MPLIF was 16.6°. Twenty-six of the 42 patients (61.9 %) had post-operative SVA values less than 47 mm. Nineteen of the 42 patients (45.2 %) had average post-operative LL within 11° of the PI. Sixteen of the 42 patients (38.1 %) had PT less than 22°. Younger age, female gender and a low pre-operative PT were significantly associated with the attainment of a satisfactory sagittal alignment.
  
  
  
  Our results demonstrate that a satisfactory correction can be achieved in degenerative scoliosis with MPLIF. In addition, our results show that it is significantly more likely to achieve a satisfactory radiological outcome in younger, female patients with low pre-operative PT.
authors.affiliation: Department of Spinal Surgery, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK. silviusabou@yahoo.com.
authors.forename: Silviu
authors.identifier: 0000-0002-0477-7920
authors.initials: S
authors.lastname: Sabou
authors.affiliation: Department of Spinal Surgery, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
authors.forename: Tzu-Heng Jason
authors.initials: TH
authors.lastname: Tseng
authors.affiliation: School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
authors.forename: John
authors.initials: J
authors.lastname: Stephenson
authors.affiliation: Department of Spinal Surgery, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
authors.forename: Irfan
authors.initials: I
authors.lastname: Siddique
authors.affiliation: Department of Spinal Surgery, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
authors.forename: Rajat
authors.initials: R
authors.lastname: Verma
authors.affiliation: Department of Spinal Surgery, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
authors.forename: Saeed
authors.initials: S
authors.lastname: Mohammad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008141:Lordosis / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D011184:Postoperative Period; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D012720:Severity of Illness Index; D013122:Spinal Diseases / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*
keywords: Degenerative scoliosis; Lumbar lordosis; Posterior lumbar interbody fusion; Sagittal alignment; Spinopelvic alignment