307 - The Relationship between Low Back Pain and Lumbar Sagittal Alignment a...

#307 The Relationship between Low Back Pain and Lumbar Sagittal Alignment after Lumbar Fusion

Lumbar Therapies and Outcomes

Poster Presented by: N. Shao

Author(s):

Y. Hai (1)
N. Shao (2)
H. Zhao (1)
Y. Liu (1)

(1) Beijing Chaoyang Hospital, Capital Medical University, Orthopedic Surgery, Beijing, China
(2) General Coal Hospital, Beijing, China

Abstract

Objective: In order to evaluated the relationship between low back pain and change of lumbar spine sagittal alignment after lumbar spine fusion, a retrospective study was conducted.

Methods: Between January and December 2008, 182 consecutive patients with degenerative lumbar spine diseases were treated with Posterior Lumbar Interbody Fusion (PLIF) and those patients who had follow up for more than 24 months were included in the study. Standing lumbar spine AP and lateral X-rays were taken during the follow up and the lumbar lordosis Cobb angles were measured on the X-ray. The pain degrees were assessed by the VAS and ODI. The relationship between the change of the Cobb angle and change of lumbar sagittal plane curve was analyzed by the SPSS software. Meantime, the relationship between the back pain degree and Cobb angle was investigated.

Results: 42 of all the 182 cases, who suffered back pain after surgery, had get more than 24 months fellow-up, including 19 males and 23 females, aged form 40 to 77 (mean, 59.6). The lumbar spine sagittal Cobb angles were measured from the X ray image:

The lumbar lordosis angle:

① the mean angle at 12 months fellow-up: 40.1°±10.6°, range: 20°-60°;
② the mean angle at 24 months fellow-up: 40.8°±10°, range: 24°-60°.

The back pain of the 42 patients: VAS:

① the mean at 12 months fellow-up: 29.4±11.5, range: 5-50;
② the mean at 24 months fellow-up: 27.6±11.7, range: 25-48.

The lumbar spine function of the 42 patients: ODI:

① the mean at 12 months fellow-up: 15.1±5.4, range: 0-25;
② the mean at 24 months fellow-up: 13.9±5.2, range: 0-24.

The difference between the lumbar lordosis angle and the standard score:

① the mean angle at 12 months fellow-up: 19.9°±10.6°, range: 0°-40°;
② the mean angle at 24 months fellow-up: 19.2°±10.0°, range: 0°-36°.

The evaluation on the relationship between the former deference and the back pain VAS Result:

① at 12 months fellow-up: P< 0.001, Positive correlation
② at 24 months fellow-up: P< 0.001, Positive correlation;

The evaluation on the relationship between the former deference and the back pain ODI Result:

① at 12 months fellow-up: P< 0.001, Positive correlation;
② at 24 months fellow-up: P< 0.001, Positive correlation.

Conclusion: The Relationship between The Back Pain after Lumbar Fusion Treatment and loss of Lumbar Sagittal lordosis was very tight. Moreover, the reconstruction of lumbar lordosis should be one goal for the lumbar fusion surgery.

Keywords: Back pain, Lumbar Sagittal Plane Curve, fusion