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Minimally Invasive Lateral Lumbar Interbody Fusion for Adult Spinal Deformity
- Source :
- Spine. 43:E813-E821
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- A retrospective cohort study.To evaluate the clinical and radiological efficacies of supplementing minimally invasive lateral lumbar interbody fusion (LLIF) with open posterior spinal fusion (PSF) in adult spinal deformity (ASD).Minimally invasive techniques have been increasingly applied for surgery of ASD. Few reports have been published that directly compare LLIF combined with PSF to conventional PSF for ASD.To evaluate the advantages of minimally invasive LLIF for ASD, patients who underwent minimally invasive LLIF followed by open PSF (combined group) were compared with patients who only underwent PSF (only PSF group). The clinical and radiological outcomes for deformity correction and indirect decompression were assessed. The occurrence of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) were also evaluated.No significant differences were observed in the clinical outcomes of the Oswestry Disability Index (ODI), visual analog scale, and major complications including reoperations between the groups. No additional advantage was found for coronal deformity correction, but the restoration of lumbar lordosis in the combined group was significantly higher postoperatively (15.3° vs. 8.87°, P = 0.003) and last follow-up (6.69° vs. 1.02°, P = 0.029) compared to that of the only PSF group. In the subgroup analysis for indirect decompression for the combined group, a significant increase of canal area (104 vs. 122 mm) and foraminal height (16.2 vs. 18.5 mm) was noted. The occurrence of PJK or PJF was significantly higher in the combined group than in the only PSF group (P = 0.039).LLIF has advantages of indirect decompression and greater improvements of sagittal correction compared to only posterior surgery. LLIF should be conducted considering the above-mentioned benefits and complications including PJK or PJF in ASD.4.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
MEDLINE
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Lumbar interbody fusion
Humans
Minimally Invasive Surgical Procedures
Medicine
Orthopedics and Sports Medicine
Aged
Retrospective Studies
030222 orthopedics
Lumbar Vertebrae
business.industry
Follow up studies
Retrospective cohort study
Middle Aged
Surgery
Spinal Fusion
Treatment Outcome
Radiological weapon
Spinal fusion
Spinal deformity
Female
Spinal Diseases
Neurology (clinical)
business
030217 neurology & neurosurgery
Follow-Up Studies
Cohort study
Subjects
Details
- ISSN :
- 15281159 and 03622436
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- Spine
- Accession number :
- edsair.doi.dedup.....a17e4f49eb0b644bd53538dfb9eda265