The Effect of an Adjustable Hinged Operating Table on Lumbar Lordosis during Lumbar Surgery

Arjun Sebastian, Amin Ahmed, Brian Vernon, Emily C. Nguyen, Ilyas Aleem, Michelle J. Clarke, Bradford L. Currier, Paul Anderson, Mohamad Bydon, Ahmad Nassr

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN.: Prospective observational study OBJECTIVES.: Quantify the amount of lumbar lordosis achieved on a hinged operative table in neutral, flexion, and extension. SUMMARY OF BACKGROUND DATA.: Hinged operative tables may allow surgeons to adjust lumbar spine positioning intraoperatively. The amount of lumbar lordosis in neutral, flexion, and extension positions has not been quantified prospectively using a hinged table. METHODS.: Thirty patients undergoing elective lumbar surgery were enrolled. Standing x-rays taken in neutral, maximal flexion, and maximal extension were obtained. Following prone positioning on a hinged operative table, x-rays in neutral, maximal flexion, and maximal extension were taken. Total lumbar lordosis was calculated for all 6 images by two physicians. Disc degeneration was graded using Pfirrmann grades. RESULTS.: Lumbar lordosis on the operative table was 56.5?±?2.1, 43.6?±?2.2, 63.2?±?2.0 compared to 46.9?±?3.1, 33.2?±?2.8, 52.3?±?3.3 on the standing films in neutral, flexion, and extension respectively. Average flexion (12.9?±?1.1) and extension (6.7?±?1.2) were significantly different from neutral on the table (p?<?.001). Lumbar lordosis was significantly higher on the operative table (p?<?.001). Total range of motion was 19.6?±?1.9 on the table and 19.1?±?2.0 with standing (p?=?0.42). Average Pfirrmann disc grade was 2.77?±?0.10 which did not correlate with range of motion (p?=?0.40). CONCLUSIONS.: In this cohort, the hinged operative table allowed for a physiologic arc of motion of nearly 20 from flexion to extension. A considerable amount of lumbar sagittal motion can be obtained on hinged operative tables without decreasing overall lumbar lordosis below physiologic levels.Level of Evidence: 3

Original languageEnglish (US)
JournalSpine
DOIs
StateAccepted/In press - Jul 24 2017

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Operating Tables
Lordosis
Articular Range of Motion
X-Rays
Intervertebral Disc Degeneration
Observational Studies
Spine
Prospective Studies
Physicians

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Sebastian, A., Ahmed, A., Vernon, B., Nguyen, E. C., Aleem, I., Clarke, M. J., ... Nassr, A. (Accepted/In press). The Effect of an Adjustable Hinged Operating Table on Lumbar Lordosis during Lumbar Surgery. Spine. https://doi.org/10.1097/BRS.0000000000002345

The Effect of an Adjustable Hinged Operating Table on Lumbar Lordosis during Lumbar Surgery. / Sebastian, Arjun; Ahmed, Amin; Vernon, Brian; Nguyen, Emily C.; Aleem, Ilyas; Clarke, Michelle J.; Currier, Bradford L.; Anderson, Paul; Bydon, Mohamad; Nassr, Ahmad.

In: Spine, 24.07.2017.

Research output: Contribution to journalArticle

Sebastian, A, Ahmed, A, Vernon, B, Nguyen, EC, Aleem, I, Clarke, MJ, Currier, BL, Anderson, P, Bydon, M & Nassr, A 2017, 'The Effect of an Adjustable Hinged Operating Table on Lumbar Lordosis during Lumbar Surgery', Spine. https://doi.org/10.1097/BRS.0000000000002345
Sebastian, Arjun ; Ahmed, Amin ; Vernon, Brian ; Nguyen, Emily C. ; Aleem, Ilyas ; Clarke, Michelle J. ; Currier, Bradford L. ; Anderson, Paul ; Bydon, Mohamad ; Nassr, Ahmad. / The Effect of an Adjustable Hinged Operating Table on Lumbar Lordosis during Lumbar Surgery. In: Spine. 2017.
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abstract = "STUDY DESIGN.: Prospective observational study OBJECTIVES.: Quantify the amount of lumbar lordosis achieved on a hinged operative table in neutral, flexion, and extension. SUMMARY OF BACKGROUND DATA.: Hinged operative tables may allow surgeons to adjust lumbar spine positioning intraoperatively. The amount of lumbar lordosis in neutral, flexion, and extension positions has not been quantified prospectively using a hinged table. METHODS.: Thirty patients undergoing elective lumbar surgery were enrolled. Standing x-rays taken in neutral, maximal flexion, and maximal extension were obtained. Following prone positioning on a hinged operative table, x-rays in neutral, maximal flexion, and maximal extension were taken. Total lumbar lordosis was calculated for all 6 images by two physicians. Disc degeneration was graded using Pfirrmann grades. RESULTS.: Lumbar lordosis on the operative table was 56.5?±?2.1, 43.6?±?2.2, 63.2?±?2.0 compared to 46.9?±?3.1, 33.2?±?2.8, 52.3?±?3.3 on the standing films in neutral, flexion, and extension respectively. Average flexion (12.9?±?1.1) and extension (6.7?±?1.2) were significantly different from neutral on the table (p?<?.001). Lumbar lordosis was significantly higher on the operative table (p?<?.001). Total range of motion was 19.6?±?1.9 on the table and 19.1?±?2.0 with standing (p?=?0.42). Average Pfirrmann disc grade was 2.77?±?0.10 which did not correlate with range of motion (p?=?0.40). CONCLUSIONS.: In this cohort, the hinged operative table allowed for a physiologic arc of motion of nearly 20 from flexion to extension. A considerable amount of lumbar sagittal motion can be obtained on hinged operative tables without decreasing overall lumbar lordosis below physiologic levels.Level of Evidence: 3",
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AU - Sebastian, Arjun

AU - Ahmed, Amin

AU - Vernon, Brian

AU - Nguyen, Emily C.

AU - Aleem, Ilyas

AU - Clarke, Michelle J.

AU - Currier, Bradford L.

AU - Anderson, Paul

AU - Bydon, Mohamad

AU - Nassr, Ahmad

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N2 - STUDY DESIGN.: Prospective observational study OBJECTIVES.: Quantify the amount of lumbar lordosis achieved on a hinged operative table in neutral, flexion, and extension. SUMMARY OF BACKGROUND DATA.: Hinged operative tables may allow surgeons to adjust lumbar spine positioning intraoperatively. The amount of lumbar lordosis in neutral, flexion, and extension positions has not been quantified prospectively using a hinged table. METHODS.: Thirty patients undergoing elective lumbar surgery were enrolled. Standing x-rays taken in neutral, maximal flexion, and maximal extension were obtained. Following prone positioning on a hinged operative table, x-rays in neutral, maximal flexion, and maximal extension were taken. Total lumbar lordosis was calculated for all 6 images by two physicians. Disc degeneration was graded using Pfirrmann grades. RESULTS.: Lumbar lordosis on the operative table was 56.5?±?2.1, 43.6?±?2.2, 63.2?±?2.0 compared to 46.9?±?3.1, 33.2?±?2.8, 52.3?±?3.3 on the standing films in neutral, flexion, and extension respectively. Average flexion (12.9?±?1.1) and extension (6.7?±?1.2) were significantly different from neutral on the table (p?<?.001). Lumbar lordosis was significantly higher on the operative table (p?<?.001). Total range of motion was 19.6?±?1.9 on the table and 19.1?±?2.0 with standing (p?=?0.42). Average Pfirrmann disc grade was 2.77?±?0.10 which did not correlate with range of motion (p?=?0.40). CONCLUSIONS.: In this cohort, the hinged operative table allowed for a physiologic arc of motion of nearly 20 from flexion to extension. A considerable amount of lumbar sagittal motion can be obtained on hinged operative tables without decreasing overall lumbar lordosis below physiologic levels.Level of Evidence: 3

AB - STUDY DESIGN.: Prospective observational study OBJECTIVES.: Quantify the amount of lumbar lordosis achieved on a hinged operative table in neutral, flexion, and extension. SUMMARY OF BACKGROUND DATA.: Hinged operative tables may allow surgeons to adjust lumbar spine positioning intraoperatively. The amount of lumbar lordosis in neutral, flexion, and extension positions has not been quantified prospectively using a hinged table. METHODS.: Thirty patients undergoing elective lumbar surgery were enrolled. Standing x-rays taken in neutral, maximal flexion, and maximal extension were obtained. Following prone positioning on a hinged operative table, x-rays in neutral, maximal flexion, and maximal extension were taken. Total lumbar lordosis was calculated for all 6 images by two physicians. Disc degeneration was graded using Pfirrmann grades. RESULTS.: Lumbar lordosis on the operative table was 56.5?±?2.1, 43.6?±?2.2, 63.2?±?2.0 compared to 46.9?±?3.1, 33.2?±?2.8, 52.3?±?3.3 on the standing films in neutral, flexion, and extension respectively. Average flexion (12.9?±?1.1) and extension (6.7?±?1.2) were significantly different from neutral on the table (p?<?.001). Lumbar lordosis was significantly higher on the operative table (p?<?.001). Total range of motion was 19.6?±?1.9 on the table and 19.1?±?2.0 with standing (p?=?0.42). Average Pfirrmann disc grade was 2.77?±?0.10 which did not correlate with range of motion (p?=?0.40). CONCLUSIONS.: In this cohort, the hinged operative table allowed for a physiologic arc of motion of nearly 20 from flexion to extension. A considerable amount of lumbar sagittal motion can be obtained on hinged operative tables without decreasing overall lumbar lordosis below physiologic levels.Level of Evidence: 3

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