Effect of sagittal balance on risk of falling after lateral lumbar interbody fusion surgery combined with posterior surgery

Byung Ho Lee, Jae Ho Yang, Hak Sun Kim, Kyung Soo Suk, Hwan Mo Lee, Jin Oh Park, Seong Hwan Moon

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Purpose: To demonstrate the impact of correcting sagittal balance (SB) on functional outcomes of surgical treatment for degenerative spinal disease and actual falls via utilization of new minimally invasive lumbar fusion techniques via a lateral approach. Materials and Methods: From November 2011 to March 2015, we enrolled 56 patients who underwent minimally invasive lateral lumbar interbody fusion (LLIF) and matched 112 patients receiving decompression/postero-lateral fusion (PLF) surgery for lumbar spinal stenosis. According to SB status using C7-plumb line-distance (C7PL) and surgery type, patients were divided into three groups: SB PLF, sagittal imbalance (SI) PLF, and LLIF groups. We then compared their outcomes. Results: The mean C7PL was 6.2±13.6 mm in the SB PLF group, 72.9±33.8 mm in the SI PLF group, and 74.8±38.2 mm in the LLIF group preoperatively. Postoperatively, C7PL in only the LLIF group improved significantly (p=0.000). Patients in the LLIF group showed greater improvement in fall-related functional test scores than the SI PLF group (p=0.007 for Alternate-Step test, p=0.032 for Sit-to-Stand test). The average number of postoperative falls was 0.4±0.7 in the SB PLF group, 1.1±1.4 in the SI PLF group, and 0.8±1.0 in the LLIF group (p=0.041). Oswestry Disability Index and the Euro-QoL 5 dimension visual analogue scale scores also showed greater improvements in the LLIF group than in the SI PLF group at postoperative 1 year (p=0.003, 0.016). Conclusion: Surgical correction of SI in patients with lumbar spinal stenosis using a combination of minimal invasive LLIF and posterior surgery achieved better surgical outcomes and a lower incidence of actual falls than PLF surgery.

Original languageEnglish
Pages (from-to)1177-1185
Number of pages9
JournalYonsei medical journal
Issue number6
Publication statusPublished - 2017 Nov

Bibliographical note

Funding Information:
This study was partially supported by Catholic-Kwandong University Research fund (CKURF-2016-0484-0001). This study was mainly performed in the Severance Hospital and Gangnam Severance Hospital, College of Medicine, Yonsei University.

Publisher Copyright:
© Yonsei University College of Medicine 2017.

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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