Évaluation clinique de l’importance du rétablissement de la lordose lombaire sur les résultats des arthrodèses lombaires courtes

Abstract : Study design: prospective study. Objective: to correlate the restoration of lumbar lordosis and the clinical scores in patients who underwent short lumbar fusion for degenerative pathology. Methods: it was a prospective study including patients from January 2011 to December 2016 with a lumbar fusion of 1 to 3 levels maximum. Patients were all included in a prospective database after agreement. The analysis of clinical parameters (ODI, EVA, SF-12) and radiological parameters (pelvic parameters, LL, SSA, VAS, ODHA) was performed preoperatively, early postoperative phase and at the last follow-up. Statistical analysis was performed using Graphpad Prism7 © software. All tests are performed with a significance of 95%. Results: 78 patients were included with a mean follow-up 49.13 months. At last follow-up, the ODI was improved by 22 points, the lumbar VAS by 3 points, the SF-12 by 9.29 points of PCS, and 6.05 points of MCS. Clinical improvement was statistically significant with p <0.001. Restoration of lumbar lordosis was statistically greater at last follow-up (7.01 vs 4.3), p = 0.002. The correlation study did not show a correlation between lumbar lordosis restitution and clinical improvement. Subgroup analysis showed a significant correlation between lumbar lordosis restoration and ODI, and a correlation between SSA and ODI at last follow-up in the degenerative spondylolisthesis treatment group. The surgical revision rate for adjacent segment disease was 6.41%. Discussion-Conclusion: this study found a significant correlation between lumbar lordosis restitution and ODI in patients treated for degenerative spondylolisthesis. It did not show this correlation for all patients certainly due to a lack of power. The surgical revision rate for adjacent syndrome is low compared to the literature.
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Master Thesis
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Marion Petit. Évaluation clinique de l’importance du rétablissement de la lordose lombaire sur les résultats des arthrodèses lombaires courtes. Médecine humaine et pathologie. 2018. ⟨dumas-02077250⟩

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