Relationship Between The Change Of Sagittal Plane Balance And The Treatment Outcomes After Internal Fixation In Lumbar Spondylolisthesis

Objective To explore the effects of transforaminal lumbar interbody fusion(TLIF)with single segment or double segment fixation on sagittal parameters of degenerative lumbar spondylolisthesis and its relationship with clinical outcomes.Methods The clinical and imaging data of 44 patients with degenerative lumbar spondylolisthesis(32 cases of grade I and 12 cases of grade II)undergoing TLIF were retrospectively analyzed.The patients were divided into single segment fixation group(29 cases)and double fixation group(15 cases).The sagittal parameters of the X-ray of the total spine were measured before and after the surgery,including spino-sacral angle(SSA),T1 pelvic angle(TPA),lumbar lordosis angle(LL),pelvic incidence angle(PI),pelvic tilt(PT),sacral slope(SS),and the visual analogue scale(VAS)score,Japanese Orthopedic Association(JOA)score and Oswestry disability index(ODI)were evaluated.Results All the patients were followed up for 3-10 months with an average of 6months.SSA,TPA,LLA and SS increased,and PT decreased after operation in all the patients,and diffrerences were statistically significant(P<0.05).The VAS score,JOA score and ODI were significantly improved after operation,and the differences werestatistically significant(P<0.05).The LL and ODI deference value in single segment group were more significantly than those in double segment group,and the diffrerences were statistically significant(P<0.05).The LL difference value was correlated with the ODI difference value in the 2 groups.The SSA difference values was associated with 2 values in the single segment group.Conclusion Grade I or II degree of degenerative lumbar spondylolisthesis treated with TLIF can improve the spinal sagittal parameters,and single segment fixation is more conducive to the postoperative spinal sagittal parameters improve.