scholarly journals Clinical Outcomes after Minimally Invasive Trans-Psoas Lateral Lumbar Interbody Fusion for the Treatment of Adult Degenerative Scoliosis: Four Years’ Multicenter Study

2020 ◽  
Vol 9 (03) ◽  
pp. 225-229
Author(s):  
Sheikh Asad ◽  
Arjun Dubey ◽  
Arvind Dubey ◽  
Chester Sutterlin
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Interbody Fusion ◽  
Degenerative Scoliosis ◽  
Lumbar Scoliosis ◽  
Adult Degenerative Scoliosis ◽  
Outcome Scores

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.

scholarly journals Clinical Outcomes of Extreme Lateral Interbody Fusion in the Treatment of Adult Degenerative Scoliosis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Adam M. Caputo ◽  
Keith W. Michael ◽  
Todd M. Chapman ◽  
Gene M. Massey ◽  
Cameron R. Howes ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Degenerative Lumbar Scoliosis ◽  
Degenerative Scoliosis ◽  
Lateral Interbody Fusion ◽  
Adult Degenerative Scoliosis ◽  
Outcome Scores ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody

Introduction. The use of extreme lateral interbody fusion (XLIF) and other lateral access surgery is rapidly increasing in popularity. However, limited data is available regarding its use in scoliosis surgery. The objective of this study was to evaluate the clinical outcomes of adults with degenerative lumbar scoliosis treated with XLIF.Methods. Thirty consecutive patients with adult degenerative scoliosis treated by a single surgeon at a major academic institution were followed for an average of 14.3 months. Interbody fusion was completed using the XLIF technique with supplemental posterior instrumentation. Validated clinical outcome scores were obtained on patients preoperatively and at most recent follow-up. Complications were recorded.Results. The study group demonstrated improvement in multiple clinical outcome scores. Oswestry Disability Index scores improved from 24.8 to 19.0 (P < 0.001). Short Form-12 scores improved, although the change was not significant. Visual analog scores for back pain decreased from 6.8 to 4.6 (P < 0.001) while scores for leg pain decreased from 5.4 to 2.8 (P < 0.001). A total of six minor complications (20%) were recorded, and two patients (6.7%) required additional surgery.Conclusions. Based on the significant improvement in validated clinical outcome scores, XLIF is effective in the treatment of adult degenerative scoliosis.

scholarly journals Minimally invasive anterior lumbar interbody fusion for adult degenerative scoliosis with 1 or 2 dislocated levels

2015 ◽  
Vol 23 (6) ◽  
pp. 739-746 ◽  
Author(s):  
Charles-Henri Flouzat-Lachaniette ◽  
Louis Ratte ◽  
Alexandre Poignard ◽  
Jean-Charles Auregan ◽  
Steffen Queinnec ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Anterior Lumbar Interbody Fusion ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Degenerative Scoliosis ◽  
Surgical Morbidity ◽  
Adult Degenerative Scoliosis ◽  
The Mean

OBJECT Frequent complications of posterolateral instrumented fusion have been reported after treatment of degenerative scoliosis in elderly patients. Considering that in some cases, most of the symptomatology of adult degenerative scoliosis (ADS) is a consequence of the segmental instability at the dislocated level, the use of minimally invasive anterior lumbar interbody fusion (ALIF) to manage symptoms can be advocated to reduce surgical morbidity. The purpose of this study was to evaluate the midterm outcomes of 1- or 2-level minimally invasive ALIFs in ADS patients with 1- or 2-level dislocations. METHODS A total of 47 patients (average age 64 years; range 43–80 years) with 1- or 2-level ALIF performed for ADS (64 levels) in a single institution were included in the study. An independent spine surgeon retrospectively reviewed all the patients’ medical records and radiographs to assess operative data and surgery-related complications. Clinical outcome was reported using the Oswestry Disability Index (ODI) and the visual analog scale (VAS) for lumbar and leg pain. Intraoperative data and complications were collected. Fusion and risk for adjacent-level degeneration were assessed. RESULTS The mean follow-up duration was 3 years (range 1–10 years). ODI, and back and leg pain VAS scores were significantly improved at last follow-up. A majority of patients (74%) had a statistically significant improvement in their ODI score of more than 20 points at latest follow-up and 1 had a worsening of his disability. The mean operating time was 166 minutes (range 70–355 minutes). The mean estimated blood loss was 410 ml (range 50–1700 ml). Six (5 major and 1 minor) surgical complications (12.7% of patients) and 13 (2 major and 11 minor) medical complications (27.7% of patients) occurred without death or wound infection. Fusion was achieved in 46 of 47 patients. Surgery resulted in a slight but significant decrease of the Cobb angle, and improved the pelvic parameters and lumbar lordosis, but had no effect on the global sagittal balance. At latest follow-up, 9 patients (19.1%) developed adjacent-segment disease at a mean of 2 years’ delay from the index surgery; 4 were symptomatic but treated medically, and none required iterative surgery. CONCLUSIONS Single- or 2-level minimally invasive fusion through a minimally invasive anterior approach in some selected cases of ADS produced a good functional outcome with a high fusion rate. They were associated with a significantly lower rate of complications in this study than the historical control.

Comparison of Clinical Outcomes and Complications Between Percutaneous Endoscopic and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 24 (6) ◽  
pp. 441-452
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Lumbar Interbody Fusion ◽  
Degenerative Lumbar Disease

BACKGROUND: Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has been increasingly used to treat degenerative lumbar disease in recent years. However, there are still controversies about whether PE-TLIF is superior to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). OBJECTIVES: To compare clinical outcomes and complications of PE-TLIF and MIS-TLIF in treating degenerative lumbar disease. STUDY DESIGN: A systematic review and meta-analysis. METHODS: A comprehensive search of online databases including PubMed, Embase, and the Cochrane Library was performed to identify related studies reporting the outcomes and complications of PE-TLIF and MIS-TLIF for degenerative lumbar disease. The clinical outcomes were assessed by the Visual Analog Scale and Oswestry Disability Index. In addition, the operative time, intraoperative blood loss, time to ambulation, length of hospital stay, fusion rate, and surgery-related complications were summarized. Forest plots were constructed to investigate the results. RESULTS: A total of 28 studies involving 1,475 patients were included in this meta-analysis. PE-TLIF significantly reduced operative time, intraoperative blood loss, time to ambulation, and length of hospital stay compared to MIS-TLIF. Moreover, PE-TLIF was superior to MIS-TLIF in the early postoperative relief of back pain. However, there were no significant differences in medium to long-term clinical outcomes, fusion rate, and incidence of complications between PE-TLIF and MIS-TLIF. LIMITATIONS: The current evidence is heterogeneous and most studies included in this meta-analysis are nonrandomized controlled trials. CONCLUSIONS: The present meta-analysis indicates that medium to long-term clinical outcomes and complication rates of PE-TLIF were similar to MIS-TLIF for the treatment of degenerative lumbar disease. However, PE-TLIF shows advantages in less surgical trauma, faster recovery, and early postoperative relief of back pain. KEY WORDS: Percutaneous endoscopic transforaminal lumbar interbody fusion, minimally invasive transforaminal lumbar interbody fusion, degenerative lumbar disease, chronic pain, systematic review, meta-analysis

Comparison between oblique lumbar interbody fusion and posterior lumbar interbody fusion in the treatment of degenerative lumbar scoliosis: a retrospective clinical study

2020 ◽  
Author(s):  
chaojun Xu ◽  
Yingjie HAO ◽  
Lei YU ◽  
Guangduo ZHU ◽  
Zhinan REN ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Length Of Hospital Stay ◽  
Vertical Axis ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Interbody Fusion ◽  
Lumbar Scoliosis ◽  
Significant Difference ◽  
Oblique Lumbar Interbody Fusion

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

scholarly journals Minimally invasive L5–S1 oblique lumbar interbody fusion with anterior plate

2016 ◽  
Vol 41 (videosuppl1) ◽  
pp. 1
Author(s):  
Martin H. Pham ◽  
Andre M. Jakoi ◽  
Patrick C. Hsieh
Keyword(s):  
Minimally Invasive ◽  
Degenerative Disc Disease ◽  
Interbody Fusion ◽  
Deformity Correction ◽  
Lumbar Interbody Fusion ◽  
Degenerative Scoliosis ◽  
Anterior Plate ◽  
Disc Disease ◽  
Case Presentation ◽  
Oblique Lumbar Interbody Fusion

Lumbar interbody fusion is an important technique for the treatment of degenerative disc disease and degenerative scoliosis. The oblique lumbar interbody fusion (OLIF) establishes a minimally invasive retroperitoneal exposure anterior to the psoas and lumbar plexus. In this video case presentation, the authors demonstrate the techniques of the OLIF at L5–S1 performed on a 69-year-old female with degenerative scoliosis as one component of an overall strategy for her deformity correction.The video can be found here: https://youtu.be/VMUYWKLAl0g.

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