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Correction of marked sagittal deformity with circumferential minimally invasive surgery using oblique lateral interbody fusion in adult spinal deformityopen access

Authors
Park S.W.Ko M.J.Kim Y.B.Le Huec J.C.
Issue Date
Jan-2020
Publisher
BioMed Central Ltd.
Keywords
Adult spinal deformity; Marked sagittal deformity; Minimally invasive spine surgery; Oblique lateral interbody fusion; Percutaneous fixation; Sagittal correction
Citation
Journal of Orthopaedic Surgery and Research, v.15, no.1
Journal Title
Journal of Orthopaedic Surgery and Research
Volume
15
Number
1
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/37962
DOI
10.1186/s13018-020-1545-7
ISSN
1749-799X
Abstract
Background: Spinal surgery performed entirely with minimally invasive surgery is referred to as circumferential MIS (cMIS). However, cMIS still has a limited sagittal correction capability for adult spinal deformity (ASD) with a marked sagittal deformity. We investigated the effectiveness of cMIS using oblique lateral interbody fusion (OLIF) and percutaneous posterior spine fixation in correcting marked sagittal deformity. Methods: This study retrospectively evaluated 23 patients with ASD with marked sagittal deformity who underwent cMIS using OLIF without osteotomy and were followed-up for at least 24 months (whole group). The whole group was divided into the following two groups according to the type of interbody fusion at L5-S1: The OLIF51 group (n = 13) underwent OLIF at L1-L5 and L5-S1 and the TLIF51 group (n = 10) underwent OLIF at L1-L5 and transforaminal lumbar interbody fusion (TLIF) at L5-S1. Results: Sagittal vertebral axis (SVA; 125.7 vs. 29.5 mm, p < 0.001), lumbar lordosis (LL; 18.2° vs. 51.7°, p < 0.001), and pelvic incidence-LL mismatch (PI-LL, 35.5° vs. 5.3°) significantly improved postoperatively in the whole group. The OLIF51 group showed significantly higher postoperative LL than the TLIF51 group (55.5° vs. 46.9°, p < 0.001). OLIF yielded a significantly greater disc angle at L5-S1 than did TLIF (18.4° vs. 6.9°, p < 0.001). Proximal junctional kyphosis occurred significantly earlier in the OLIF51 group than in the TLIF51 group (8.6 vs. 26.3 months, p < 0.001). Conclusion: Successful sagittal correction in ASD patients with marked sagittal deformity was achieved with cMIS using OLIF. OLIF at L5-S1 showed a synergistic effect in sagittal deformity correction by cMIS. © 2020 The Author(s).
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Park, Seung Won
의과대학 (의학부(임상-광명))
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