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Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study – Lumbar Fusion

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This article discusses the use of anterior column realignment (ACR) in combination with oblique lumbar interbody fusion (OLIF) and/or anterior lumbar interbody fusion (ALIF) for the correction of adult spinal deformity (ASD). The study analyzed patients who underwent OLIF and/or ALIF and ACR treatment between 2018 and 2021. The results showed that the combined surgical approach had significant advantages in restoring intervertebral space angulation and correcting sagittal balance. Patients experienced improvements in intervertebral space angle, lumbar lordosis, visual analog pain score, and Japanese orthopedic association scores. The incidence of surgical complications was relatively low. Overall, the study suggests that the combination of OLIF or ALIF with ACR is an effective and minimally invasive approach for correcting spinal sagittal balance in patients with ASD

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: ACR via a minimally invasive hybrid approach for ASD has significant advantages in restoring local intervertebral space angulation and correcting the overall sagittal balance. Simultaneously, it can achieve good clinical outcomes and fewer surgical complications.

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BMC Musculoskelet Disord. 2023 Dec 19;24(1):979. doi: 10.1186/s12891-023-07106-1.ABSTRACTBACKGROUND: Anterior column realignment (ACR) is a novel surgical method for correcting spinal sagittal balance. meanwhile, oblique lumbar interbody fusion (OLIF) and anterior lumbar interbody fusion (ALIF) are considered minimally invasive surgical methods through natural anatomical space. This study aimed to explore the corrective effects and clinical outcomes,

BMC Musculoskelet Disord. 2023 Dec 19;24(1):979. doi: 10.1186/s12891-023-07106-1.

ABSTRACT

BACKGROUND: Anterior column realignment (ACR) is a novel surgical method for correcting spinal sagittal balance. meanwhile, oblique lumbar interbody fusion (OLIF) and anterior lumbar interbody fusion (ALIF) are considered minimally invasive surgical methods through natural anatomical space. This study aimed to explore the corrective effects and clinical outcomes of OLIF or ALIF combined with ACR technology in patients with adult spinal deformity (ASD).

METHODS: We retrospectively analyzed patients with sagittal imbalance who received OLIF and/or ALIF and ACR treatment from 2018 to 2021. Surgical time and intraoperative bleeding volume are recorded, the corrective effect is determined by the intervertebral space angle (IVA), lumbar lordosis (LL), the sagittal vertical axis (SVA), clinical outcome is evaluated by preoperative and final follow-up visual analog pain score (VAS), Japanese orthopedic association scores (JOA) and complications.

RESULTS: Sixty-four patients were enrolled in the study, average age of 65.1(range, 47-82) years. All patients completed 173 fusion segments, for 150 segments of ACR surgery. The operation time of ALIF-ACR was 50.4 ± 22.1 min; The intraoperative bleeding volume was 50.2 ± 23.6 ml. The operation time and intraoperative bleeding volume of single-segment OLIF-ACR was 66.2 ± 19.4 min and 70.2 ± 31.6 ml. At the follow-up of 6 months after surgery, the intervertebral space angle correction for OLIF-ACR and ALIF-ACR is 9.2° and 12.2°, the preoperative and postoperative lumbar lordosis were 16.7° ± 6.4°and 47.1° ± 3.6° (p < 0.001), VAS and JOA scores were improved from 6.8 to 1.8 and 7.8 to 22.1 respectively, statistically significant differences were observed in these parameters. The incidence of surgical related complications is 29.69%, but without serious complications.

: ACR via a minimally invasive hybrid approach for ASD has significant advantages in restoring local intervertebral space angulation and correcting the overall sagittal balance. Simultaneously, it can achieve good clinical outcomes and fewer surgical complications.

PMID:38114995 | DOI:10.1186/s12891-023-07106-1

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Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study

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BMC Musculoskelet Disord. 2023 Dec 19;24(1):979. doi: 10.1186/s12891-023-07106-1.ABSTRACTBACKGROUND: Anterior column realignment (ACR) is a novel surgical method for correcting spinal sagittal balance. meanwhile, oblique lumbar interbody fusion (OLIF) and anterior lumbar interbody fusion (ALIF) are considered minimally invasive surgical methods through natural anatomical space. This study aimed to explore the corrective effects and clinical outcomes

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