Dataset Information

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study.

ABSTRACT:

Background

Anterior column realignment (ACR) is a novel surgical method for correcting spinal sagittal balance. meanwhile, oblique lumbar interbody fusion (OLIF) and anterior lumbar interbody fusion (ALIF) are considered minimally invasive surgical methods through natural anatomical space. This study aimed to explore the corrective effects and clinical outcomes of OLIF or ALIF combined with ACR technology in patients with adult spinal deformity (ASD).

Methods

We retrospectively analyzed patients with sagittal imbalance who received OLIF and/or ALIF and ACR treatment from 2018 to 2021. Surgical time and intraoperative bleeding volume are recorded, the corrective effect is determined by the intervertebral space angle (IVA), lumbar lordosis (LL), the sagittal vertical axis (SVA), clinical outcome is evaluated by preoperative and final follow-up visual analog pain score (VAS), Japanese orthopedic association scores (JOA) and complications.

Results

Sixty-four patients were enrolled in the study, average age of 65.1(range, 47-82) years. All patients completed 173 fusion segments, for 150 segments of ACR surgery. The operation time of ALIF-ACR was 50.4 ± 22.1 min; The intraoperative bleeding volume was 50.2 ± 23.6 ml. The operation time and intraoperative bleeding volume of single-segment OLIF-ACR was 66.2 ± 19.4 min and 70.2 ± 31.6 ml. At the follow-up of 6 months after surgery, the intervertebral space angle correction for OLIF-ACR and ALIF-ACR is 9.2° and 12.2°, the preoperative and postoperative lumbar lordosis were 16.7° ± 6.4°and 47.1° ± 3.6° (p < 0.001), VAS and JOA scores were improved from 6.8 to 1.8 and 7.8 to 22.1 respectively, statistically significant differences were observed in these parameters. The incidence of surgical related complications is 29.69%, but without serious complications.

Conclusion

ACR via a minimally invasive hybrid approach for ASD has significant advantages in restoring local intervertebral space angulation and correcting the overall sagittal balance. Simultaneously, it can achieve good clinical outcomes and fewer surgical complications.

SUBMITTER: Feng DP

PROVIDER: S-EPMC10729504 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

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Publications

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study.

Feng Da Peng DP Liu Ming Quan MQ Zhang Wei W Wang Jia Qi JQ Li Zheng Wei ZW

BMC musculoskeletal disorders 20231219 1

<h4>Background</h4>Anterior column realignment (ACR) is a novel surgical method for correcting spinal sagittal balance. meanwhile, oblique lumbar interbody fusion (OLIF) and anterior lumbar interbody fusion (ALIF) are considered minimally invasive surgical methods through natural anatomical space. This study aimed to explore the corrective effects and clinical outcomes of OLIF or ALIF combined with ACR technology in patients with adult spinal deformity (ASD).<h4>Methods</h4>We retrospectively an ...[more]

PMID: 38114995

Similar Datasets

Project description:BackgroundSagittal malalignment is associated with poor quality of life. Correction of lumbar lordosis through anterior column release (ACR) has been shown to improve overall sagittal alignment, however typically in combination with long posterior constructs and associated morbidity. The technical feasibility and radiographic outcomes of short-segment anterior or lateral minimally invasive surgery (MIS) ACR techniques in moderate to severe lumbar sagittal deformity were evaluated.MethodsConsecutive patients treated with short-segment MIS ACR techniques for moderate to severe lumbar sagittal deformity correction were retrospectively analyzed from a prospectively collected database. Clinical outcomes included perioperative measures of invasiveness, including operative time, blood loss, complications, and average length of stay. Radiographic outcomes included measurement of preoperative, immediate postoperative, and long-term follow-up radiographic parameters including coronal Cobb angle, lumbar lordosis (LL), pelvic incidence (PI), PI-LL mismatch, pelvic tilt (PT), T1 pelvic angle (TPA), T1 spino-pelvic inclination (T1SPI), proximal junctional angle (PJA), and sagittal vertical axis (SVA).ResultsThe cohort included 34 patients (mean age 63) who were treated at an average 2.5 interbody levels (range 1-4) through a lateral or anterior approach (LLIF or ALIF). Of 89 total interbody levels treated, 63 (71%) were ACR levels. Posterior fixation was across an average of 3.2 levels (range 1-5). Mean total operative time and blood loss were 362 minutes and 621 mL. Surgical complications occurred in 2 (5.9%). Average hospital stay was 5.5 days (including staging). At last follow-up (average 25.4 months; range 0.5-7 years), all patients (100%) demonstrated successful achievement of one or more alignment goal, with significant improvements in coronal Cobb, LL, PI-LL mismatch, PT, and TPA. No patient was revised for PJK.ConclusionsThese data show that short-segment MIS ACR correction of moderate to severe lumbar sagittal deformity is feasible and effective at achieving overall alignment goals with low procedural morbidity and risk of proximal junctional issues.

Dataset Information

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study.

Background

Methods

Results

Conclusion

Publications

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study.

Similar Datasets

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