Curve Laterality for Lateral Lumbar Interbody Fusion in Grownup Scoliosis Surgical procedure: The Concave Versus Convex Controversy.
Neurosurgery. 2018 Jan 18;:
Authors: Kanter AS, Tempel ZJ, Agarwal N, Hamilton DK, Zavatsky JM, Mundis GM, Tran S, Chou D, Park P, Uribe JS, Wang MY, Anand N, Eastlack R, Mummaneni PV, Okonkwo DO
BACKGROUND: Minimally invasive lateral lumbar interbody fusion (LLIF) is an efficient adjunct in grownup degenerative scoliosis (ADS) surgical procedure. LLIF approaches carried out from the concavity or convexity have inherent approach-related dangers and advantages.
OBJECTIVE: To research LLIF approach-related problems and radiographic and medical outcomes in sufferers with ADS.
METHODS: A multicenter retrospective evaluation of a minimally invasive grownup spinal deformity database was queried with a minimal of 2-yr follow-up. Sufferers have been divided into 2 teams as decided by the facet of the curve from which the LLIF was carried out: concave or convex.
RESULTS: No variations between teams have been famous in demographic, and preoperative or postoperative radiographic parameters (all P > .05). There have been eight whole problems within the convex group (34.eight%) and 21 problems within the concave group (52.5%; P = .17). A subgroup evaluation was carried out in 49 sufferers in whom L4-5 was within the main curve and never within the fractional curve. On this subset of sufferers, there have been 6 problems within the convex group (31.6%) in comparison with 19 within the concave group (63.three%; P < .05) and each teams skilled vital enhancements in coronal Cobb angle, Oswestry Incapacity Index, and Visible Analog Scale rating with no distinction between teams.
CONCLUSION: Sufferers present process LLIF for ADS had no statistically vital medical or operative complication charges no matter a concave or convex strategy to the curve. Scientific outcomes and coronal aircraft deformity improved no matter strategy facet. Nevertheless, in circumstances whereby L4-5 is within the main curve, approaching the fractional curve at L4-5 from the concavity could also be related to the next complication charge in comparison with a convex strategy.
PMID: 29361052 [PubMed – as supplied by publisher]