Functional outcome analysis: instrumented posterior lumbar interbody fusion for degenerative lumbar scoliosis

2010 ◽  
Vol 153 (3) ◽  
pp. 547-555 ◽  
Author(s):  
Tai-Hsin Tsai ◽  
Tzuu-Yuan Huang ◽  
Ann-Shung Lieu ◽  
Kung-Shing Lee ◽  
Sui-Sum Kung ◽  
...  
2020 ◽  
Author(s):  
chaojun Xu ◽  
Yingjie HAO ◽  
Lei YU ◽  
Guangduo ZHU ◽  
Zhinan REN ◽  
...  

Abstract Backgroud Few studies compared radiographic and clinical outcomes between oblique lumbar interbody fusion and posterior lumbar interbody fusion in degenerative lumbar scoliosis. Methods This study retrospectively analyzed the case data of 40 patients with degenerative lumbar scoliosis in our hospital from July 2016 to October 2018. Among which,19 cases underwent oblique lumbar Interbody fusion(OLIF group) and 21 cases underwent posterior lumbar interbody fusion(PLIF group). The duration of the operation, volume of intraoperative hemorrhage, incision length, bed rest time, length of hospital stay, and complications were recorded for all patients. The clinical effects of 40 patients were evaluated by VAS for back pain and Oswestry Disability Index (ODI) and The radiographic parameters were evaluated using the lumbar scoliosis Cobb angle, sagittal vertical axis(SVA), coronal vertical axis(CVA), lumbar lordosis(LL), pelvic tilt(PT), sacral slope(SS), and Disc height(DH). Results The duration of the operation, the volume of intraoperative hemorrhage, incision length, bed rest time, length of hospital stay of the OLIF group were shorter than the PLIF group( P < 0.05 ). The VAS scores for back pain, the ODI of the two groups were significantly decreased, which compared with the preoperative( P < 0.05 ),which in OLIF group was significantly more decreased than in PLIF( P < 0.05 ) at 7 days and 3 months postoperatively, but at the last follow-up there were no significant difference between the two groups( P > 0.05 ); The lumbar scoliosis Cobb angle, SVA, CVA, PT, LL, SS were significantly improved postoperatively( P < 0.05 ). The OLIF group showed higher DH, smaller Cobb angle, and greater LL than the PLIF group at any time point( P < 0.05 ). but there were no significant difference in SVA, CVA, PT and SS between the two groups at any follow-up points( P > 0.05 ). The overall complication rate was slightly higher in the PLIF group(47.62%)than in the OLIF group(26.32%)without significant difference(x 2 =1.931, P =0.165). But the incidence of major complications in the PLIF group was significantly higher than that in the OLIF group (Fisher, P =0.026). Conclusion OLIF provides an alternative minimally invasive treatment for DLS, which compared with PLIF. It has the characteristics of a small incision, rapid recovery, fewer complications related to the surgical approach, and satisfactory orthopedics. Keywords : Minimally invasive, Oblique lumbar interbody fusion, Degenerative adult lumbar scoliosis , Posterior lumbar interbody fusion


2008 ◽  
Vol 21 (5) ◽  
pp. 310-315 ◽  
Author(s):  
Chin-Hsien Wu ◽  
Chak-Bor Wong ◽  
Lih-Huei Chen ◽  
Chi-Chien Niu ◽  
Tung-Ting Tsai ◽  
...  

Author(s):  
Harpreet Singh ◽  
Dhruv Patel ◽  
Sangam Tyagi ◽  
Krushna Saoji ◽  
Tilak Patel ◽  
...  

<p class="abstract"><strong>Background:</strong> Spondylolisthesis is condition in which one vertebra slips over other vertebra. This study has been done to compare the functional outcome and complications of two techniques: posterior lumbar fusion (intertransverse fusion) and posterior lumbar interbody fusion.</p><p class="abstract"><strong>Methods:</strong> Total 20 patients with spondylolisthesis admitted in a tertiary care centre in Rajasthan were allotted alternatively in posterior lumbar fusion (PLF) group and posterior lumbar interbody fusion (PLIF) group. In PLF, fusion was done by placing bone graft between transverse processes and around facets. In PLIF, fusion was bone by placing cage in between vertebral bodies.</p><p class="abstract"><strong>Results:</strong> 20 patients were included in our study with female predominance (65%). Mean age was 54.2 years (PLF=58.4 and PLIF=50.2). 70% patients have L4-L5 level spondylolisthesis. Average operative time was less in PLF group, which is statistically significant. Functional outcome was measured by using visual analogue scale (VAS) score and Japanese orthopedics association score (JOAS) at 3 weeks, 3 months and 6 months. There is a significant decrease between preoperative VAS and at 6 months, in both PLF and PLIF group. JOAS was significantly increased at 6 months in both PLF and PLIF group as compared to preoperative score. But difference in JOAS at 6 months is not significant between PLF and PLIF.</p><p class="abstract"><strong>Conclusions:</strong> Both PLF and PLIF are equally effective for spondylolisthesis. Both techniques have same satisfactory results. As PLIF is more invasive technique, more operative time and more complications are seen.</p>


2018 ◽  
Vol 8 (7) ◽  
pp. 722-727 ◽  
Author(s):  
Shinya Okuda ◽  
Tomoya Yamashita ◽  
Tomiya Matsumoto ◽  
Yukitaka Nagamoto ◽  
Tsuyoshi Sugiura ◽  
...  

Study Design: Retrospective study. Objective: There have been few reports of adjacent segment disease (ASD) after posterior lumbar interbody fusion (PLIF) with large numbers and long follow-up. The purpose of this study was to investigate (1) ASD incidence and time periods after primary PLIF, (2) repeat ASD incidence and time periods, and (3) ASD incidence and time periods by fusion length, age, and preoperative pathologies. Methods: A total of 1000 patients (average age 67 years, average follow-up 8.3 years) who underwent PLIF for degenerative lumbar disorders were reviewed. ASD was defined as a symptomatic condition in which revision surgery was required. Results: The overall ASD rate was 9.0%, and the average ASD period was 4.7 years after primary surgery. With respect to clinical features of ASD, degenerative spondylolisthesis at the cranial fusion segment was the most frequent. In terms of repeat ASD, second and third ASD incidences were 1.1% and 0.4%, respectively. As for ASD by fusion length, age, and preoperative pathologies, ASD incidence was increased by fusion length, while the time period to ASD was significantly shorter in elderly patients and those with degenerative lumbar scoliosis. Conclusions: In the present study, the overall ASD incidence was 9.0%, and the average ASD period was 4.7 years after primary operation. Second and third ASD incidences were 1.1% and 0.4%, respectively. Fusion length affected the ASD incidence, while aging factor and preoperative pathology affected the ASD time period.


2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Xiangyao Sun ◽  
Zhaoxiong Chen ◽  
Siyuan Sun ◽  
Wei Wang ◽  
Tongtong Zhang ◽  
...  

This study evaluated differences in outcome variables between dynamic stabilization adjacent to fusion (DATF) and posterior lumbar interbody fusion (PLIF) for the treatment of lumbar degenerative disease. A systematic review of PubMed, EMBASE, and Cochrane was performed. The variables of interest included clinical adjacent segment pathologies (CASPs), radiological adjacent segment pathologies (RASPs), lumbar lordosis (LL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery (DS), estimated blood loss (EBL), complications, and reoperation rate. Nine articles identified as meeting all of the inclusion criteria. DATF was better than PLIF in proximal RASP, CASP, and ODI during 3 months follow-up, VAS-L. However, no significant difference between DATF and PLIF was found in distal RASP, LL, JOA score, VAS-B, ODI after 3 months follow-up, complication rates, and reoperation rate. These further confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The differences between hybrid surgery and topping-off technique were located in DS and EBL in comparison with PLIF. Our study confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to the fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The difference between hybrid surgery and topping-off technique was not significant in treatment outcomes.


2021 ◽  
Vol 9 (1) ◽  
pp. 34-40
Author(s):  
Dr. Lalit C. Panchal ◽  
◽  
Dr. Vijay L Sarukte ◽  
Dr. Ravi N Bhanushali ◽  
◽  
...  

Background: Functional outcome following instrumental spinal surgery for spondylolisthesis inphysically energetic patients is crucial. The present study was undertaken to evaluate the functionaloutcome of low-grade spondylolisthesis accompanied by low back pain with or without radiculopathy,with standard surgical procedure posterior lumbar interbody fusion with instrumentation. Method:In this study total of 40 patients were operated on for low-grade spondylolisthesis by posteriorstabilization using a pedicular screw rod system and posterior lumbar interbody fusion. All thepatients were followed up till 6 months after surgery and functional outcomes were noted. Results:Assessment of this series it was observed that, 57.5% of the patient had excellent outcome, 37.5%had a good outcome and 97.5% of the study population had satisfactory outcome (improvement inclinical results). There was a significant improvement in pain intensity, walking, lifting, standing,sleeping after surgery. The mean ODI difference between preoperative and post-operative at 6months follow up was 36.12% (16.75). In the outcome, 62.5% of the patient consisted of severedisability and 32.5% were with moderate disability (total-95%) while postoperative 87.5% were witha minimal disability and only 2.5% of the study population had worsened i.e crippled. Conclusion:The study concluded that surgery in form of decompression with instrumentation and posteriorlumbar interbody is a safe and effective method to treat spondylolisthesis.


2020 ◽  
Vol 9 (03) ◽  
pp. 225-229
Author(s):  
Sheikh Asad ◽  
Arjun Dubey ◽  
Arvind Dubey ◽  
Chester Sutterlin

AbstractThe use of minimally invasive transpsoas lateral lumbar interbody fusion (LLIF) surgery for treatment of adult degenerative scoliosis is rapidly increasing in popularity. However, limited data is available regarding its use in adult degenerative lumbar scoliosis surgery. The objective of this study was to evaluate the clinical outcomes of adults with degenerative lumbar scoliosis who were treated with minimally invasive LLIF. Thirty-two consecutive patients with adult degenerative scoliosis treated by a single surgeon at two spine centers were followed up for an average of 13.2 months. Interbody fusion was completed using the minimally invasive LLIF technique with supplemental 360 degrees’ posterior instrumentation. Oswestry disability index (ODI) scores were obtained preoperatively and at most recent follow-up. Complications were recorded. The study group demonstrated improvement in clinical outcome scores. ODI scores improved from 36.8 to 23.4 (p < 0.00001). A total of four complications (12%) were recorded, and two patients (6%) required additional surgery. Based on the significant improvement in validated clinical outcome scores, minimally invasive LLIF can be considered an effective procedure in the treatment of adult degenerative scoliosis.


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