Conditions for Achieving Postoperative Pelvic Incidence-Lumbar Lordosis < 10° in Circumferential Minimally Invasive Surgery for Adult Spinal Deformity

Journal of Clinical Medicine

Yoichi Tani¹  Masaaki Paku¹  Masayuki Ishihara¹  Muneharu Ando¹  Takanori Saito¹  Shinichirou Taniguchi¹  Takashi Adachi¹ 

[1] Department of Orthopedic Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata City 573-1191, Japan;

关键词: adult spinal deformity;    lateral lumbar interbody fusion;    percutaneous pedicle screw;    circumferential minimally invasive surgery;    lumbosacral fusion;   

DOI  :  10.3390/jcm11061586

来源: DOAJ

【 摘 要 】

This retrospective study aimed to evaluate the clinical outcomes of circumferential minimally invasive surgery (CMIS) using lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screw (PPS) in adult spinal deformity (ASD) patients, and to clarify the conditions for achieving postoperative pelvic incidence-lumbar lordosis (PI-LL) < 10°. Demographics and other parameters of ASD patients who underwent CMIS and who were divided into groups G (achieved postoperative PI-LL < 10°) and P (PI-LL ≥ 10°) were compared. Of the 145 included ASD patients who underwent CMIS, the average fused level, bleeding volume, operative time, and number of intervertebral discs that underwent LLIF were 10.3 ± 0.5 segments, 723 ± 375 mL, 366 ± 70 min, and 4.0 segments, respectively. The rod material was titanium alloy in all the cases. The PI-LL significantly improved from 37.3 ± 17.9° to 1.2 ± 12.2° postoperatively. Pre- and postoperative PI, postoperative LL, preoperative PI-LL, PI-LL after LLIF, and postoperative PI-LL were significantly larger in group P. PI-LL after LLIF was identified as a significant risk factor of postoperative PI-LL < 10° by logistic regression, and the cut-off value on receiver operating characteristic curve analysis was 20°. Sufficient correction was achieved by CMIS. If PI-LL after LLIF was ≤20°, it was corrected to the ideal alignment by the PPS procedure.

【 授权许可】

Unknown