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Surgical approaches and short-term results of circumferential minimally invasive correction surgery for adult idiopathic scoliosis – Published Article

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The article presents the surgical techniques and short-term results of circumferential minimally invasive spine surgery (CMIS) with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screw (PPS) application for adult idiopathic scoliosis (AS). The study includes eight AS patients who underwent CMIS and examines various factors such as the number of fused levels, instrumented vertebrae, LLIF-treated segments, preoperative fusions, blood loss, operative time, spinopelvic parameters, disability and pain scores, bone fusion rate, and complications. The results show significant improvements in spinopelvic parameters, disability and pain scores, and high bone fusion rates. The study concludes that CMIS with LLIF and PPS can achieve good postoperative outcomes for AS, emphasizing the importance of correcting global alignment in addition to scoliosis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: The 2-year postoperative results of CMIS for AS were good, and spontaneous bone fusion was confirmed in the thoracic spine without bone grafting. In this procedure, sufficient intervertebral release with LLIF and a PPS device translation technique enabled adequate global alignment correction. Therefore, correcting the global imbalance of the coronal and sagittal planes is more crucial than correcting scoliosis.

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World Neurosurg. 2023 Jul 5:S1878-8750(23)00913-0. doi: 10.1016/j.wneu.2023.06.131. Online ahead of print.ABSTRACTOBJECTIVE: We present the surgical approaches and short-term (2 years postoperative) results pertaining to circumferential minimally invasive spine surgery (CMIS) with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screw (PPS) application for adult idiopathic scoliosis (AS).METHODS: We enrolled eight patients with AS who underwent,

World Neurosurg. 2023 Jul 5:S1878-8750(23)00913-0. doi: 10.1016/j.wneu.2023.06.131. Online ahead of print.

ABSTRACT

OBJECTIVE: We present the surgical approaches and short-term (2 years postoperative) results pertaining to circumferential minimally invasive spine surgery (CMIS) with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screw (PPS) application for adult idiopathic scoliosis (AS).

METHODS: We enrolled eight patients with AS who underwent CMIS (2018-2020) and examined the number of fused levels, upper instrumented vertebra (UIV), lower instrumented vertebra (LIV), number of LLIF-treated segments, number of preoperative intervertebral fusions, intraoperative blood loss, operative time, various spinopelvic parameters, Oswestry Disability Index (ODI), low back pain, visual analog scale (VAS), leg VAS, bone fusion rate, and perioperative complications.

RESULTS: The UIV was T4, T7, T8, and T9 in two cases, whereas LIV was the pelvis in all the cases. The average numbers of fixed vertebrae and segments that underwent LLIF were 13.3±2.0 and 4.6±0.7, respectively. All spinopelvic parameters improved significantly after surgery (TK: p<0.05, LL, CA, PT, PI-LL, SVA: p<0.001), and good alignment was achieved. The ODI and VAS scores improved significantly (p<0.001). The bone fusion rates achieved in the lumbosacral and thoracic spine were 100% and 88%, respectively. Only one patient showed postoperative coronal imbalance.

CONCLUSIONS: The 2-year postoperative results of CMIS for AS were good, and spontaneous bone fusion was confirmed in the thoracic spine without bone grafting. In this procedure, sufficient intervertebral release with LLIF and a PPS device translation technique enabled adequate global alignment correction. Therefore, correcting the global imbalance of the coronal and sagittal planes is more crucial than correcting scoliosis.

PMID:37419315 | DOI:10.1016/j.wneu.2023.06.131

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Surgical approaches and short-term results of circumferential minimally invasive correction surgery for adult idiopathic scoliosis

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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World Neurosurg. 2023 Jul 5:S1878-8750(23)00913-0. doi: 10.1016/j.wneu.2023.06.131. Online ahead of print.ABSTRACTOBJECTIVE: We present the surgical approaches and short-term (2 years postoperative) results pertaining to circumferential minimally invasive spine surgery (CMIS) with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screw (PPS) application for adult idiopathic scoliosis (AS).METHODS: We enrolled eight patients with AS who underwent

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