Diaz-Aguilar Luis, Stone Lauren E, Soliman Mohamed A R, Padovano Alexander, Ehresman Jeff, Brown Nolan J, Produturi Gautam, Battista Madison, Khan Asham, Pollina John, Amaral Rodrigo, Abd-El-Barr Muhammad M, Moss Isaac, Smith Tyler, Deol Gurvinder S, Lee Bryan S, McMains M Craig, Joseph Samuel A, Schwartz David, Pimenta Luiz, Nguyen Andrew D, Taylor William R
1Department of Neurological Surgery, University of California, San Diego, La Jolla, California.
2Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Neurosurg Focus. 2023 Jan;54(1):E3. doi: 10.3171/2022.10.FOCUS22603.
The aim of this paper was to evaluate the changes in radiographic spinopelvic parameters in a large cohort of patients undergoing the prone transpsoas approach to the lumbar spine.
A multicenter retrospective observational cohort study was performed for all patients who underwent lateral lumber interbody fusion via the single-position prone transpsoas (PTP) approach. Spinopelvic parameters from preoperative and first upright postoperative radiographs were collected, including lumbar lordosis (LL), pelvic incidence (PI), and pelvic tilt (PT). Functional indices (visual analog scale score), and patient-reported outcomes (Oswestry Disability Index) were also recorded from pre- and postoperative appointments.
Of the 363 patients who successfully underwent the procedure, LL after fusion was 50.0° compared with 45.6° preoperatively (p < 0.001). The pelvic incidence-lumbar lordosis mismatch (PI-LL) was 10.5° preoperatively versus 2.9° postoperatively (p < 0.001). PT did not significantly change (0.2° ± 10.7°, p > 0.05).
The PTP approach allows significant gain in lordotic augmentation, which was associated with good functional results at follow-up.
本文旨在评估一大群接受俯卧经腰大肌入路腰椎手术患者的影像学脊柱骨盆参数变化。
对所有通过单体位俯卧经腰大肌（PTP）入路行腰椎侧方椎间融合术的患者进行多中心回顾性观察队列研究。收集术前及术后首次站立位X线片的脊柱骨盆参数，包括腰椎前凸（LL）、骨盆入射角（PI）和骨盆倾斜角（PT）。还记录术前及术后门诊的功能指标（视觉模拟评分）和患者报告结局（Oswestry功能障碍指数）。
363例成功接受手术的患者中，融合后腰椎前凸为50.0°，术前为45.6°（p < 0.001）。术前骨盆入射角与腰椎前凸不匹配度（PI - LL）为10.5°，术后为2.9°（p < 0.001）。骨盆倾斜角无显著变化（0.2°±10.7°，p > 0.05）。
PTP入路可显著增加腰椎前凸，且与随访时良好的功能结果相关。
