19 Harley St, London, W1G 9QJ, UK

Lumbar lordosis restoration by minimally invasive short-segment fusion with anterior column realignment for adult spinal deformity: minimum 2-year follow-up – Lumbar Fusion

Day Case Lumbar Fusion Surgery

The article discusses the efficacy of anterior column realignment (ACR) in a select group of adult spinal deformity (ASD) patients. The study focused on a minimally invasive surgery (MIS) triad, which included ACR, lateral lumbar interbody fusion, and percutaneous pedicle screw fixation, with the aim of shortening fusion length without compromising outcomes. The study included 61 ASD patients with a mean age of 72.8 years and a pelvic incidence (PI) – lumbar lordosis (LL) mismatch of more than 10°. The results showed significant improvements in spinopelvic deformity parameters and Oswestry Disability Index (ODI) scores. The patients were divided into two groups based on postoperative evaluation, with those whose PI-LL improved to less than 10° and those with a mismatch greater than 10°. Logistic regression analysis showed preoperative PI-LL mismatch as the only factor that significantly influenced this separation. The study concludes that the MIS triad is an excellent surgical option for ASD patients with a preoperative PI-LL mismatch of less than 26.4°, but it can also be effective for those with a greater mismatch, although ideal spinopelvic alignment targets may not be achieved in these patients

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spine hospital in UK

Published article

S: As long as the ASD characteristics are consistent with the authors’ exclusion criteria, the short-segment MIS triad served as an excellent surgical option in the patients with preoperative PI-LL mismatch < 26.4°, but the technique also worked well even in those with a mismatch > 26.4°, although ideal spinopelvic alignment targets were not necessarily achieved in these patients.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
J Neurosurg Spine. 2023 Nov 17:1-10. doi: 10.3171/2023.9.SPINE23829. Online ahead of print.ABSTRACTOBJECTIVE: The efficacy of anterior column realignment (ACR) remains relatively unclear, possibly because some safety concerns have limited its adoption and extensive evaluation. The authors aimed to study whether a minimally invasive surgery (MIS) triad consisting of ACR, lateral lumbar interbody fusion, and percutaneous,

J Neurosurg Spine. 2023 Nov 17:1-10. doi: 10.3171/2023.9.SPINE23829. Online ahead of print.

ABSTRACT

OBJECTIVE: The efficacy of anterior column realignment (ACR) remains relatively unclear, possibly because some safety concerns have limited its adoption and extensive evaluation. The authors aimed to study whether a minimally invasive surgery (MIS) triad consisting of ACR, lateral lumbar interbody fusion, and percutaneous pedicle screw fixation in a select group of adult spinal deformity (ASD) patients helps shorten fusion length without compromising clinical and radiographic outcomes over a minimum 2-year follow-up period.

METHODS: A series of 61 ASD patients (mean age 72.8 years) with pelvic incidence (PI) – lumbar lordosis (LL) (PI-LL) mismatch > 10° underwent the short-segment MIS triad (mean fusion length 3.0 levels) as a single-stage operation with a mean operative time and estimated blood loss of 157 minutes and 127 mL, respectively. Exclusion criteria were 1) thoracic scoliosis as the main deformity, 2) thoracolumbar junction kyphosis > 25°, 3) ankylosed facet joints, and 4) previous spinal fusion surgery. Seven patients, who needed fusion to be extended to S1, underwent mini-open transforaminal lumbar interbody fusion at L5-S1.

RESULTS: The segmental disc angle at the ACR level more than quintupled, averaging from 2.9° preoperatively to 18.9° at the latest follow-up (p < 0.0001). LL, in turn, nearly doubled from 17.0° to 32.8° (p < 0.0001) and PI-LL decreased by nearly half from 28.8° to 13.2° (p < 0.0001). At the same time, other spinopelvic deformity parameters as well as Oswestry Disability Index (ODI) scores significantly improved. Patients were divided into two groups at the latest postoperative evaluation: 36 patients whose PI-LL improved to < 10° and 25 patients who maintained a PI-LL mismatch > 10°. Binary logistic regression revealed preoperative PI-LL mismatch as the only factor that significantly influenced this dichotomous separation postoperatively. Receiver operating characteristic curve analysis identified the critical preoperative mismatch of 26.4° with 68% sensitivity and 84% specificity. Despite this different radiographic consequence, the two groups had an equally successful clinical outcome with no significant difference in ODI scores.

S: As long as the ASD characteristics are consistent with the authors’ exclusion criteria, the short-segment MIS triad served as an excellent surgical option in the patients with preoperative PI-LL mismatch < 26.4°, but the technique also worked well even in those with a mismatch > 26.4°, although ideal spinopelvic alignment targets were not necessarily achieved in these patients.

PMID:37976518 | DOI:10.3171/2023.9.SPINE23829

The London Spine Unit : most established spine hospital in UK

Read the original publication:

Lumbar lordosis restoration by minimally invasive short-segment fusion with anterior column realignment for adult spinal deformity: minimum 2-year follow-up

Related Posts

0/5 (0 Reviews)

Trusindex Reviews

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile

 

What our patients say ...

J Neurosurg Spine. 2023 Nov 17:1-10. doi: 10.3171/2023.9.SPINE23829. Online ahead of print.ABSTRACTOBJECTIVE: The efficacy of anterior column realignment (ACR) remains relatively unclear, possibly because some safety concerns have limited its adoption and extensive evaluation. The authors aimed to study whether a minimally invasive surgery (MIS) triad consisting of ACR, lateral lumbar interbody fusion, and percutaneous

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£1130
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD
Popular

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810