Correcting Degenerative Lumbar Spine Deformity by Stand-Alone Anterior Oblique Lumbar Interbody Fusion

Document Type : Original Article

Authors

1 Neurosurgery, Faculty of medicine, Suez Canal University, Ismailia, Egypt

2 neurosurgery department, Suez canal university

3 Neurosurgery departmwnt, Suez Canal University, Egypt

4 Neurosurgery Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

5 Neurosurgery Dept., Suez Canal University

6 The Centre for Spinal Studies and Surgery (CSSS), Queens Medical Centre Campus, Nottingham University Hospitals NHS Trust, Derby Rd, Nottingham NG7 2UH, UK

Abstract

Background Data: Adult degenerative scoliosis has at its starting point the same broader definition of adult scoliosis, which is defined as a Cobb angle of greater than 10 degrees measured in the coronal plane. However, it is exclusive for adults who previously had normal spinal alignment. Such pathology with no specific etiology results from a combination of degenerative lumbar diseases. Oblique lumbar interbody fusion (OLIF) is one of the fusion techniques used. It was introduced to overcome the disadvantages of the commonly used interbody fusions like anterior (ALIF), lateral (LLIF), or posterior (PLIF) interbody fusions. OLIF can achieve spinal stability, correct alignment in coronal and sagittal balance anteriorly, and indirectly decompress neural structures with fewer complications related to traditional transpsoas or retropsoas approaches.
Study Design: Prospective clinical case study.
Objective: To assess the degree of coronal and sagittal deformity correction in patients suffering from degenerative lumbar spine deformities after stand-alone (SA) OLIF.
Patients and Methods: Patients with ADS following specific inclusion criteria underwent SA OLIF. Pre- and postoperative clinical data (back and leg pain VAS and ODI), radiological data (spinopelvic parameters, segmental Cobb’s angle, and anterior disc height), and intraoperative data (operative time, amount of blood loss, “intraoperative or postoperative” complications, and hospital stay) were all analyzed and compared statistically.
Results: A total of 28 patients and 30 levels underwent operation by SA OLIF, with a mean age of 50.54 ± 6.05 years, including 14 males and 14 females. The mean operative time/min, blood loss/ml, and hospital stay/day was 91.29 ± 14.23, 195.54 ± 42.299, and 2.78 ± 0.875, respectively. The mean of back pain VAS, the mean of leg pain VAS, and ODI changed from preoperatively 7.36 ± 0.98, 6.36 ± 0.911, and 68.615 ± 8.72 to 4.07 ± 1.01, 2.07 ± 0.9, and 20.23 ± 4.7 in 1 year, respectively. The average SVA, PT, and Cobb angle decreased from 12.93, 19.21, and 10.39 to 8.93, 18.42, and 7.04 in 1 year, respectively. The average SS and LL are increased from 37.64 and 28.57 to 38.48 and 31.46 in 1 year, respectively. The average anterior disc height increased from 6.78 to 9.154 in 1 year, respectively. Postoperative complications were 1 cage dislodgement immediately postoperatively and 2 cases of cage subsidence after 1-year.
Conclusion: Stand-alone OLIF has been proved to be effective in selective cases with degenerative lumbar scoliosis, especially in restoring disc height, indirectly decompressing neural structures, correction of spinopelvic parameters, and Cobb’s angle restoration. (2021ESJ243)

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