Comparison of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion as Corrective Surgery for Patients with Adult Spinal Deformity—A Propensity Score Matching Analysis

Journal of Clinical Medicine

Yu Matsukura¹  Takashi Hirai¹  Atsuyuki Kawabata¹  Jun Hashimoto¹  Atsushi Okawa¹  Hiroyuki Inose¹  Masato Yuasa¹  Kurando Utagawa¹  Toshitaka Yoshii¹  Shingo Morishita¹  Satoru Egawa¹  Kazuyuki Otani²  Tsuyoshi Yamada²  Shigeo Shindo²  Kazuo Kusano²  Kenichiro Sakai³  Yoshiyasu Arai³  Ichiro Torigoe³  Masaki Tomori³  Kazuyuki Fukushima⁴  Shoji Tomizawa⁵  Satoshi Sumiya⁶  Fujiki Numano⁶ 

[1] Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;Department of Orthopaedic Surgery, Kudanzawa Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo 102-0074, Japan;Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi 332-8558, Japan;Department of Orthopaedic Surgery, Saku General Hospital, 3400-28 Nakagomi, Saku 385-0051, Japan;Department of Orthopaedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Toudaijima, Urayasu 279-0001, Japan;Department of Orthopaedic Surgery, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama 231-8682, Japan;

关键词: adult spinal deformity (ASD);    posterior lumbar interbody fusion;    lateral lumbar interbody fusion;    sagittal correction;    perioperative complications;    surgical invasiveness;   

DOI  :  10.3390/jcm10204737

来源: DOAJ

【 摘 要 】

Lateral lumbar interbody fusion (LLIF) is increasingly performed as corrective surgery for patients with adult spinal deformity (ASD). This paper compares the surgical results of LLIF and conventional posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) in ASD using a propensity score matching analysis. We retrospectively reviewed patients with ASD who received LLIF and PLIF/TLIF, and investigated patients’ backgrounds, radiographic parameters, and complications. The propensity scores were calculated from patients’ characteristics, including radiographic parameters and preoperative comorbidities, and one–to-one matching was performed. Propensity score matching produced 21 matched pairs of patients who underwent LLIF and PLIF/TLIF. All radiographic parameters significantly improved in both groups at the final follow-up compared with those of the preoperative period. The comparison between both groups demonstrated no significant difference in terms of postoperative pelvic tilt, lumbar lordosis (LL), or pelvic incidence–LL at the final follow-up. However, the sagittal vertical axis tended to be smaller in the LLIF at the final follow-up. Overall, perioperative and late complications were comparable in both procedures. However, LLIF procedures demonstrated significantly less intraoperative blood loss and a smaller incidence of postoperative epidural hematoma compared with PLIF/TLIF procedures in patients with ASD.

【 授权许可】

Unknown