Impact of Supine versus Prone Positioning on Segmental Lumbar Lordosis in Patients Undergoing ALIF Followed by PSF: A Comparative Study

Author:

Sadeghzadeh Sina1ORCID,Yoo Kelly H.1ORCID,Lopez Ivan1,Johnstone Thomas1,Schonfeld Ethan1ORCID,Haider Ghani1ORCID,Marianayagam Neelan J.1,Stienen Martin N.2,Veeravagu Anand1

Affiliation:

1. Department of Neurosurgery, Stanford University, 453 Quarry Road, Stanford, CA 94305, USA

2. Department of Neurosurgery & Spine Center of Eastern Switzerland, Cantonal Hospital St. Gallen, Rorschacher Str. 95, CH-9007 St. Gallen, Switzerland

Abstract

Background: Anterior lumbar interbody fusion (ALIF) and posterior spinal fusion (PSF) play pivotal roles in restoring lumbar lordosis in spinal surgery. There is an ongoing debate between combined single-position surgery and traditional prone-position PSF for optimizing segmental lumbar lordosis. Methods: This retrospective study analyzed 59 patients who underwent ALIF in the supine position followed by PSF in the prone position at a single institution. Cobb angles were measured preoperatively, post-ALIF, and post-PSF using X-ray imaging. One-way repeated measures ANOVA and post-hoc analyses with Bonferroni adjustment were employed to compare mean Cobb angles at different time points. Cohen’s d effect sizes were calculated to assess the magnitude of changes. Sample size calculations were performed to ensure statistical power. Results: The mean segmental Cobb angle significantly increased from preoperative (32.2 ± 13.8 degrees) to post-ALIF (42.2 ± 14.3 degrees, Cohen’s d: −0.71, p < 0.0001) and post-PSF (43.6 ± 14.6 degrees, Cohen’s d: −0.80, p < 0.0001). There was no significant difference between Cobb angles after ALIF and after PSF (Cohen’s d: −0.10, p = 0.14). The findings remained consistent when Cobb angles were analyzed separately for single-screw and double-screw ALIF constructs. Conclusions: Both supine ALIF and prone PSF significantly increased segmental lumbar lordosis compared to preoperative measurements. The negligible difference between post-ALIF and post-PSF lordosis suggests that supine ALIF followed by prone PSF can be an effective approach, providing flexibility in surgical positioning without compromising lordosis improvement.

Publisher

MDPI AG

Reference30 articles.

1. Increase in spinal deformity surgery in patients age 60 and older is not associated with increased complications;Sing;Spine J.,2017

2. Lumbar interbody fusion: Techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF;Mobbs;J. Spine Surg.,2015

3. Enhanced recovery after spine surgery: A systematic review;Elsarrag;Neurosurg. Focus,2019

4. Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: Long-term follow-up of three randomized controlled trials;Mannion;Spine J.,2013

5. Anterior lumbar interbody fusion for treatment of failed back surgery syndrome: An outcome analysis;Duggal;Neurosurgery,2004

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