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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2024 | Spinal Stenosis | Research article

Sagittal imbalance syndrome, a new concept, helps determining a long fusion for patients with degenerative lumbar spinal stenosis and severe global sagittal imbalance

Authors: Shibao Lu, Weiguo Zhu, Yu Wang, Chao Kong, Wei Wang, Xiaolong Chen, Xiangyu Li

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

Abstract

Objective

To retrospectively investigate the postoperative clinical and radiographic outcomes in elderly patients with degenerative lumbar spinal stenosis (DLSS) and severe global sagittal imbalance who underwent different fusion levels.

Methods

A total of 214 patients with DLSS and severe global sagittal imbalance were included. Sagittal imbalance syndrome was defined as the severe decompensated radiographic global sagittal imbalance accompanied with the following symptoms: severe back pain in naturel posture that disappears or significantly relieves in support position, living disability with ODI score > 40% and dynamic sagittal imbalance. Thereinto, 54 patients were found with sagittal imbalance syndrome and were performed the lumbar decompression with a long thoracolumbar fusion (Group A) or a short lumbar fusion (Group B). Thirty patients without sagittal imbalance syndrome who underwent short lumbar decompression and fusion were selected as the control (Group C).

Results

Patients with sagittal imbalance syndrome were detected to have more paraspinal muscle degeneration and less compensatory potentials for sagittal imbalance (smaller thoracic kyphosis and larger pelvic tilt) than those without this diagnosis. Postoperative comparisons revealed significant restoration of global sagittal alignment and balance and improvement of living quality in Groups A and C at the final follow-up. Six patients in Group B and one in Group A were found to have proximal junctional complication during follow-up.

Conclusion

Our results indicated that DLSS patients with sagittal imbalance syndrome had inferior surgical outcomes in terms of living quality and proximal junctional complication after lumbar decompression with a short fusion.

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Title: Sagittal imbalance syndrome, a new concept, helps determining a long fusion for patients with degenerative lumbar spinal stenosis and severe global sagittal imbalance
Authors: Shibao Lu
Weiguo Zhu
Yu Wang
Chao Kong
Wei Wang
Xiaolong Chen
Xiangyu Li
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Spinal Stenosis
Back Pain
Back Pain
Back Pain
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-024-04613-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sagittal imbalance syndrome, a new concept, helps determining a long fusion for patients with degenerative lumbar spinal stenosis and severe global sagittal imbalance

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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