World Neurosurgery: X (Apr 2023)
Relationship between lumbar lordosis, pelvic parameters, PI-LL mismatch and outcome after short fusion surgery for lumbar degenerative disease. Literature review, rational and presentation of public study protocol: RELApSE study (registry for evaluation of lumbar arthrodesis sagittal alignEment)
- Fulvio Tartara,
- Diego Garbossa,
- Daniele Armocida,
- Giuseppe Di Perna,
- Marco Ajello,
- Nicola Marengo,
- Marco Bozzaro,
- Salvatore Petrone,
- Pietro Domenico Giorgi,
- Giuseppe Rosario Schirò,
- Simona Legrenzi,
- Davide Boeris,
- Andrea Piazzolla,
- Anna Claudia Passarelli,
- Alessandro Longo,
- Alessandro Ducati,
- Federica Penner,
- Flavio Tancioni,
- Alberto Bona,
- Giovanni Paternò,
- Cristina Tassorelli,
- Roberto De Icco,
- Giovanni Andrea Lamaida,
- Enrico Gallazzi,
- Giulia Pilloni,
- Elena Virginia Colombo,
- Paolo Gaetani,
- Enrico Aimar,
- Cesare Zoia,
- Roberto Stefini,
- Angelo Rusconi,
- Amos M. Querenghi,
- Carlo Brembilla,
- Claudio Bernucci,
- Andrea Fanti,
- Alessandro Frati,
- Antonio Manelli,
- Vitaliano Muzii,
- Mattia Sedia,
- Alberto Romano,
- Ali Baram,
- Silvia Figini,
- Elena Ballante,
- Giuseppe Gioia,
- Marco Locatelli,
- Mauro Pluderi,
- Carlotta Morselli,
- Roberto Bassani,
- Francesco Costa,
- Fabio Cofano
Affiliations
- Fulvio Tartara
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Italy
- Diego Garbossa
- Neurosurgery, Department of Neuroscience, A.O.U. Città Della Salute e Della Scienza, University of Turin, Italy
- Daniele Armocida
- Sapienza University of Rome, Policlinico Umberto I of Rome, Rome, Italy; Corresponding author.
- Giuseppe Di Perna
- Neurosurgery, Department of Neuroscience, A.O.U. Città Della Salute e Della Scienza, University of Turin, Italy
- Marco Ajello
- Neurosurgery, Department of Neuroscience, A.O.U. Città Della Salute e Della Scienza, University of Turin, Italy
- Nicola Marengo
- Neurosurgery, Department of Neuroscience, A.O.U. Città Della Salute e Della Scienza, University of Turin, Italy
- Marco Bozzaro
- Spine Surgery Unit, Humanitas Gradenigo Hospital, Turin, Italy
- Salvatore Petrone
- Spine Surgery Unit, Humanitas Gradenigo Hospital, Turin, Italy
- Pietro Domenico Giorgi
- Orthopedics and Traumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Giuseppe Rosario Schirò
- Orthopedics and Traumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Simona Legrenzi
- Orthopedics and Traumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Davide Boeris
- Neurosurgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Andrea Piazzolla
- Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
- Anna Claudia Passarelli
- Department of Neuroscience and Organs of Sense, Orthopaedics Section, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
- Alessandro Longo
- Spine Surgery Unit, Humanitas Cellini Hospital, Turin, Italy
- Alessandro Ducati
- Spine Surgery Unit, Humanitas Cellini Hospital, Turin, Italy
- Federica Penner
- Spine Surgery Unit, Humanitas Cellini Hospital, Turin, Italy
- Flavio Tancioni
- Neurosurgery, Istituto Clinico Città Studi, Milan, Italy
- Alberto Bona
- Neurosurgery, Istituto Clinico Città Studi, Milan, Italy
- Giovanni Paternò
- Neurosurgery, Istituto Clinico Città Studi, Milan, Italy
- Cristina Tassorelli
- Chirurgia Vertebrale, Piccole Figlie Hospital, Parma, Italy
- Roberto De Icco
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Italy
- Giovanni Andrea Lamaida
- Scoliosis and Vertebral Orthopedics and Traumatology Unit, ASST Gaetano Pini - CTO, Milan, Italy
- Enrico Gallazzi
- Scoliosis and Vertebral Orthopedics and Traumatology Unit, ASST Gaetano Pini - CTO, Milan, Italy
- Giulia Pilloni
- Neurosurgery, Department of Neuroscience, A.O.U. Città Della Salute e Della Scienza, University of Turin, Italy
- Elena Virginia Colombo
- Neurosurgery, ASST Fatebenefratelli-Sacco, Milan, Italy
- Paolo Gaetani
- Vertebral Surgery Unit, Città di Pavia Clinic, Pavia, Italy
- Enrico Aimar
- Vertebral Surgery Unit, Città di Pavia Clinic, Pavia, Italy
- Cesare Zoia
- Neurosurgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
- Roberto Stefini
- Neurosurgery Unit, ASST West Milan, Legnano, Italy
- Angelo Rusconi
- Neurosurgery Unit, ASST West Milan, Legnano, Italy
- Amos M. Querenghi
- Spine Surgery Unit, Humanitas San Pio X Hospital, Milan, Italy
- Carlo Brembilla
- Neurosurgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
- Claudio Bernucci
- Neurosurgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
- Andrea Fanti
- Neurosurgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
- Alessandro Frati
- Sapienza University of Rome, Policlinico Umberto I of Rome, Rome, Italy
- Antonio Manelli
- Neurosurgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
- Vitaliano Muzii
- Neurosurgery, Policlinico Santa Maria Alle Scotte, University of Siena, Italy
- Mattia Sedia
- Spine Neurosurgery, Salus Hospital, Reggio Emilia, Italy
- Alberto Romano
- Neurosurgery, Humanitas Istituto Clinico Catanese, Catania, Italy
- Ali Baram
- Department of Neurosurgery, Humanitas Research Hospital, Rozzano, Milan, Italy
- Silvia Figini
- Statistics, Department of Political and Social Sciences, University of Pavia, Italy
- Elena Ballante
- Statistics, Department of Political and Social Sciences, University of Pavia, Italy
- Giuseppe Gioia
- Vertebral Surgery Unit, Piccole Figlie Hospital, Parma, Italy
- Marco Locatelli
- Neurosurgery, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, Italy
- Mauro Pluderi
- Neurosurgery, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico di Milano, Italy
- Carlotta Morselli
- II Spine Unit Milan, Italy, IRCCS Galeazzi Orthopedic Institute, Milan, Italy
- Roberto Bassani
- II Spine Unit Milan, Italy, IRCCS Galeazzi Orthopedic Institute, Milan, Italy
- Francesco Costa
- Spine Surgery Unit - NCH4 - Department of Neurosurgery - Fondazione IRCCS Istituto Nazionale Neurologico “C. Besta”, Milan, Italy
- Fabio Cofano
- Neurosurgery, Department of Neuroscience, A.O.U. Città Della Salute e Della Scienza, University of Turin, Italy; Spine Surgery Unit, Humanitas Gradenigo Hospital, Turin, Italy
- Journal volume & issue
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Vol. 18
p. 100162
Abstract
Background: Vertebral arthrodesis for degenerative pathology of the lumbar spine still remains burdened by clinical problems with significant negative results. The introduction of the sagittal balance assessment with the evaluation of the meaning of pelvic parameters and spinopelvic (PI-LL) mismatch offered new evaluation criteria for this widespread pathology, but there is a lack of consistent evidence on long-term outcome. Methods: The authors performed an extensive systematic review of literature, with the aim to identify all potentially relevant studies about the role and usefulness of the restoration or the assessment of Sagittal balance in lumbar degenerative disease. They present the study protocol RELApSE (NCT05448092 ID) and discuss the rationale through a comprehensive literature review. Results: From the 237 papers on this topic, a total of 176 articles were selected in this review. The analysis of these literature data shows sparse and variable evidence. There are no observations or guidelines about the value of lordosis restoration or PI-LL mismatch. Most of the works in the literature are retrospective, monocentric, based on small populations, and often address the topic evaluation partially. Conclusions: The RELApSE study is based on the possibility of comparing a heterogeneous population by pathology and different surgical technical options on some homogeneous clinical and anatomic-radiological measures aiming to understanding the value that global lumbar and segmental lordosis, distribution of lordosis, pelvic tilt, and PI-LL mismatch may have on clinical outcome in lumbar degenerative pathology and on the occurrence of adjacent segment disease.