Abstract
Objective The authors recently used a combination of minimally invasive oblique lumbar interbody fusion (OLIF) and lateral fixation for the treatment of degenerative spine deformity. The early results were promising. Radiographic and clinical results as well as complications were retrospectively assessed in the current study. Methods Eleven patients with degenerative spine deformity underwent combined OLIF and lateral instrumentation without real-time electromyography (EMG) monitoring. Radiographic measurements including coronal Cobb angle, central sacral vertebral line (CSVL), lumbar lordosis (LL), sagittal vertebral axis (SVA), pelvic tilt (PT), and LL-PI (pelvic incidence) mismatch were taken preoperatively and at last follow-up postoperatively in all patients. Concurrently, the visual analog score (VAS) for back pain and the Oswestry Disability Index (ODI) score were used to assess clinical outcomes. The fusion rate of OLIF cage, total blood loss, operation time, hospital stay, and complications were also evaluated. Results At last follow-up, all patients who underwent combined OLIF and lateral instrumentation achieved statistically significant improvement in coronal Cobb angle (from 15.3±4.7° to 5.9±3.1°, p < 0.01), LL (from 34.3±9.0° to 48.2±8.5°, p < 0.01), PT (from 24.2±9.6° to 16.2±6.0°, p < 0.01), LL-PI mismatch (from 15.4±8.7° to 7.0±3.7°, p < 0.01), CSVL (from 2.1±2.2cm to 0.7±0.9cm, p = 0.01), and SVA (from 7.0±3.9cm to 2.9±1.8cm, p < 0.01). VAS for back pain (from 6.9±1.4 to 2.0±0.9, p < 0.05) and ODI (from 39.5±3.1 to 21.9±3.6, p < 0.01) improved significantly after surgery. Conclusions A combination of OLIF and lateral instrumentation is an effective and safety means of achieving correction of both coronal and sagittal deformity, resulting in improvement of quality of life in patients with degenerative spine deformity. It is a promising way to treat patients with moderate degenerative spine deformity.
Highlights
Degenerative spine deformity is an acquired and progressive disease process that increases in frequency and severity with age [1]
It has been reported to be effective in neural decompression and providing some correction of degenerative lumbar scoliosis with less blood loss and morbidity than traditional open procedures [3, 12,13,14,15,16,17,18]
A total of 11 patients in Xuanwu Hospital between May 2017 and February 2018 were included in this study based on the following inclusion criteria: (1) diagnosis of degenerative scoliosis; (2) treatment of adult degenerative scoliosis with oblique lumbar interbody fusion (OLIF) and lateral instrumentation through the same approach in one stage; (3) availability of preoperative and postoperative 36-inch films of the scoliosis
Summary
Degenerative spine deformity is an acquired and progressive disease process that increases in frequency and severity with age [1]. Surgical treatment of degenerative spine deformity is extremely variable and ranges from limited minimally invasive procedures to extensive and lengthy multistaged operations [3, 4, 8, 9]. Traditional open approaches have been the mainstay treatment for degenerative spine deformity. The minimally invasive transpsoas lateral lumbar interbody fusion (LLIF) approach is playing an increasingly important role in the treatment of degenerative spine deformity in past decade [10, 11]. It has been reported to be effective in neural decompression and providing some correction of degenerative lumbar scoliosis with less blood loss and morbidity than traditional open procedures [3, 12,13,14,15,16,17,18]
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