Subscribe to RSS
DOI: 10.1055/s-0040-1710105
Clinical Outcomes after Minimally Invasive Trans-Psoas Lateral Lumbar Interbody Fusion for the Treatment of Adult Degenerative Scoliosis: Four Years’ Multicenter Study
Abstract
The 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.
Publication History
Article published online:
21 September 2020
© 2020. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 McAfee PC, Regan JJ, Geis WP, Fedder IL. Minimally invasive anterior retroperitoneal approach to the lumbar spine. Emphasis on the lateral BAK. Spine 1998; 23 (13) 1476-1484
- 2 Youssef JA, McAfee PC, Patty CA. et al. Minimally invasive surgery: lateral approach interbody fusion: results and review. Spine 2010; 35 (Suppl. 26) S302-S311
- 3 Acosta FL, Liu J, Slimack N, Moller D, Fessler R, Koski T. Changes in coronal and sagittal plane alignment following minimally invasive direct lateral interbody fusion for the treatment of degenerative lumbar disease in adults: a radiographic study. J Neurosurg Spine 2011; 15 (01) 92-96
- 4 Dakwar E, Cardona RF, Smith DA, Uribe JS. Early outcomes and safety of the minimally invasive, lateral retroperitoneal transpsoas approach for adult degenerative scoliosis. Neurosurg Focus 2010; 28 (03) E8
- 5 Sharma AK, Kepler CK, Girardi FP, Cammisa FP, Huang RC, Sama AA. Lateral lumbar interbody fusion: clinical and radiographic outcomes at 1 year: a preliminary report. J Spinal Disord Tech 2011; 24 (04) 242-250
- 6 Vanderpool DW, James JI, Wynne-Davies R. Scoliosis in the elderly. J Bone Joint Surg Am 1969; 51 (03) 446-455
- 7 Clavien PA, Barkun J, de Oliveira ML. et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009; 250 (02) 187-196
- 8 Cappuccino A, Cornwall GB, Turner AW. et al. Biomechanical analysis and review of lateral lumbar fusion constructs. Spine 2010; 35 (Suppl. 26) S361-S367
- 9 Dooris AP, Goel VK, Grosland NM, Gilbertson LG, Wilder DG. Load-sharing between anterior and posterior elements in a lumbar motion segment implanted with an artificial disc. Spine 2001; 26 (06) E122-E129
- 10 Oliveira L, Marchi L, Coutinho E, Pimenta L. A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements. Spine 2010; 35 (Suppl. 26) S331-S337
- 11 Laws CJ, Coughlin DG, Lotx JC, Serhan HA. Hu, SS. Spine 2012; 37: 819-825
- 12 Ozgur BM, Aryan HE, Pimenta L, Taylor WR. Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J 2006; 6 (04) 435-443
- 13 Moro T, Kikuchi S, Konno S, Yaginuma H. An anatomic study of the lumbar plexus with respect to retroperitoneal endoscopic surgery. Spine 2003; 28 (05) 423-428
- 14 Johnson RD, Valore A, Villaminar A, Comisso M, Balsano M. Pelvic parameters of sagittal balance in extreme lateral interbody fusion for degenerative lumbar disc disease. J Clin Neurosci 2013; 20 (04) 576-581
- 15 Cummock MD, Vanni S, Levi AD, Yu Y, Wang MY. An analysis of postoperative thigh symptoms after minimally invasive transpsoas lumbar interbody fusion. J Neurosurg Spine 2011; 15 (01) 11-18
- 16 Knight RQ, Schwaegler P, Hanscom D, Roh J. Direct lateral lumbar interbody fusion for degenerative conditions: early complication profile. J Spinal Disord Tech 2009; 22 (01) 34-37
- 17 Rodgers WB, Gerber EJ, Patterson J. Intraoperative and early postoperative complications in extreme lateral interbody fusion: an analysis of 600 cases. Spine 2011; 36 (01) 26-32
- 18 Houten JK, Alexandre LC, Nasser R, Wollowick AL. Nerve injury during the transpsoas approach for lumbar fusion. J Neurosurg Spine 2011; 15 (03) 280-284
- 19 Moller DJ, Slimack NP, Acosta Jr FL, Koski TR, Fessler RG, Liu JC. Minimally invasive lateral lumbar interbody fusion and transpsoas approach-related morbidity. Neurosurg Focus 2011; 31 (04) E4
- 20 Kepler CK, Sharma AK, Huang RC. et al. Indirect foraminal decompression after lateral transpsoas interbody fusion. J Neurosurg Spine 2012; 16 (04) 329-333
- 21 Le TV, Baaj AA, Dakwar E. et al. Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion. Spine 2012; 37 (14) 1268-1273
- 22 Hollowell JP, Vollmer DG, Wilson CR, Pintar FA, Yoganandan N. Biomechanical analysis of thoracolumbar interbody constructs. How important is the endplate?. Spine 1996; 21 (09) 1032-1036
- 23 Kepler CK, Huang RC, Sharma AK. et al. Factors influencing segmental lumbar lordosis after lateral transpsoas interbody fusion. Orthop Surg 2012; 4 (02) 71-75