Comparability of lateral lumbar interbody fusion (LLIF) with open versus percutaneous screw fixation for grownup degenerative scoliosis.
J Orthop. 2018 Jun;15(2):486-489
Authors: Attenello J, Chang C, Lee YP, Zlomislic V, Garfin SR, Allen RT
Examine design: Retrospective Assessment.
Targets: Evaluate medical outcomes and radiographic correction of grownup degenerative scoliosis (ADS) sufferers handled with lateral lumbar interbody fusion (LLIF), mixed both with percutaneous (no laminectomy) versus open laminectomy/pedicle screw instrumentation.
Strategies: Twenty-two ADS sufferers present process mixed LLIF and posterior instrumentation had been divided into two teams: 13 sufferers underwent LLIF with open laminectomy and posterior pedicle instrumentation (Group-1, six revision); 9 sufferers underwent LLIF with percutaneous pedicle instrumentation (no decompression) (Group-2). Radiographs, CT/MRI, peri-operative issues, VAS, SF-12, and ODI had been measured.
Outcomes: Common comply with up was 22 months. In Group-1 and Group-2, respectively: Imply coronal Cobb angle corrected 12.6° and 5.eight°; Imply regional lumbar lordosis improved 11.1° and three.eight°; Pelvic incidence minus lumbar lordosis mismatch corrected to inside +/-9° in 46% and zero% of sufferers; Imply VAS improved from 5.four to 2.eight and 6.three to 1; Imply ODI improved 19% and 22%. Enhancements had been present in SF-12 PCS and MCS scores.
Conclusions: Each open and percutaneous posterior methods following LLIF considerably improved medical outcomes. Open procedures resulted in considerably higher radiographic enhancements but in addition increased complication charges. LLIF with percutaneous posterior fixation, with out decompression, needs to be thought of a part of the algorithm in choose ADS sufferers with remaining compensatory mechanisms and understanding that higher levels of correction might require an open, extra intensive strategy.
PMID: 29881182 [PubMed]