Comparative analysis of patients’ life quality with degenerative stenosis and effectiveness of methods of calculation of lumbar lordosis correction after short-segment decompression and fusion

SUMMARY. Despite the large number of studies on sagittal balance, we were unable to find data in the literature comparing the use of different techniques for preoperative planning of lumbar lordosis correction in patients with degenerative stenosis.

AIM OF THE STUDY: to compare quality-of-life indicators and the effectiveness of methods for calculating lumbar lordosis correction in patients with degenerative stenosis during decompression and fusion on the lower lumbar spine.

MATERIALS AND METHODS: The results of clinical examination, surgical treatment, and postoperative period were analyzed in 60 patients aged 22 to 72 years (33 women and 27 men) with single- or multilevel lumbar stenosis at the L3 to S1 vertebrae grade C and D according to the Schizaz classification. Patients underwent TLIF surgery with correction of segmental lordosis at the level of the affected segment. All patients were divided into two groups of 30 depending on the method of calculation of lumbar lordosis correction: in the first group, the calculation was based on sagittal radiography of the lumbar spine and pelvis with capturing the femoral heads in standing position using the ideal lordosis formula LL=0.54×PI+27.6. In the second group, the calculation was based on whole-body sagittal radiographs using the FBI index. All patients were assessed preoperatively and postoperatively for pain on the VAS and quality of life on the ODI and RDQ scales. The postoperative follow-up period was 12 months.

RESULTS. No significant statistical differences (at p>0.05) were found between the study groups in terms of age, sex, lesion levels and their number, as well as pain level and quality of life on ODI and RDQ scales both before and after surgical treatment at 6 to 12 months. The results of changes in lumbar lordosis and other spinopelvic and global balance parameters indicate statistically significant changes in lumbar lordosis in both study groups.

CONCLUSION. In short-segment decompression and fusion interventions at the L3 to S1 level, the method of calculation of lumbar lordosis correction does not significantly affect the clinical outcome 6 to 12 months after surgical treatment.

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