MINIMALLY INVASIVE SURGICAL TREATMENT FOR ADULT DEGENERATIVE LUMBAR SCOLIOSIS
https://doi.org/10.14531/ss2014.4.49-56
Abstract
Objective. To assess the efficacy of decompression, correction, and stabilization of the lumbar spine deformity using minimally invasive techniques in patients with degenerative lumbar scoliosis.
Material and Methods. A retrospective controlled two-center study included 62 patients who underwent surgery for clinical manifestations of degenerative scoliosis of the lumbar spinal canal.
Results. Average Oswestry index before surgery was 69.69 %, after surgery it decreased to 33.00 % and ranged between 14 and 50 %. Average magnitude of the lumbar lordosis after surgery was 39.2°; average rate of deformity correction - 56.53 %; average magnitude of deformity reduced to 13.46° ± 6.08°. Two-fold reduction of the apical vertebra rotation was observed.
Conclusion. The use of the principles of minimally invasive surgery allows to expand the indications for surgical treatment of degenerative spinal deformities and the scope of intervention, and to reduce intraoperative blood loss.
About the Authors
Aleksandr Vladimirovich Krutko
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
Russian Federation
Peter Durny
Central Military Hospital, Ruzomberok, Slovakia
Russian Federation
Russian Federation
Andrey Igorevich Vasilyev
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
Russian Federation
Aleksandr Vasilyevich Bulatov
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
Russian Federation
References
1. Лебедева М.Н., Агеенко А.М., Новиков В.В. и др. Ретроспективный анализ интраоперационной кровопотери в хирургии идиопатического сколиоза. Хирургия позвоночника. 2012. № 2. С. 70-78. [Lebedeva MN, Ageenko AM, Novikov VV, et al. Retrospective Analysis of Intraoperative Blood Loss during Surgery for Idiopathic Scoliosis. Hir Pozvonoc. 2012;(2):70-78. In Russian]. doi: http://dx.doi.org/10.14531/ss2012.2.70-78.
2. Михайловский М.В., Фомичев Н.Г. Хирургия деформаций позвоночника. Новосибирск, 2002. [Mikhailovsky MV, Fomichev NG. Surgery of Spinal Deformities. Novosibirsk, 2002. In Russian].
3. Acosta FL Jr, Liu J, Slimack N, et al. Changes in coronal and sagittal plane alignment following minimally invasive direct lateral interbody fusion for the treatment of degenerative lumbar disease in adults: a radiographic study. J Neurosurg Spine. 2011;15:92-96. doi: 10.3171/2011.3.SPINE10425.
4. Aebi M. Correction of degenerative scoliosis of the lumbar spine. A preliminary report. Clin Orthop Relat Res. 1988;(232):80-86.
5. Akbarnia BA, Ogilvie JW, Hammerberg KW. Debate: degenerative scoliosis: to operate or not to operate. Spine. 2006;31(19 Suppl):S195-S201.
6. Anand N, Baron EM, Khandehroo B, et al. Long-term 2- to 5-year clinical and functional outcomes of minimally invasive surgery for adult scoliosis. Spine. 2013;38:1566-1575. doi: 10.1097/BRS.0b013e31829cb67a.
7. Anand N, Baron EM, Thaiyananthan G, et al. Minimally invasive multilevel percutaneous correction and fusion for adult lumbar degenerative scoliosis: a technique and feasibility study. J Spinal Disord Tech. 2008;21:459-467. doi: 10.1097/BSD.0b013e318167b06b.
8. Anand N, Rosemann R, Khalsa B, et al. Mid-term to long-term clinical and functional outcomes of minimally invasive correction and fusion for adults with scoliosis. Neurosurg Focus. 2010;28:E6. doi: 10.3171/2010.1.FOCUS09278.
9. Berjano P, Lamartina C. Far lateral approaches (XLIF) in adult scoliosis. Eur Spine J. 2013;22(Suppl 2):S242-S253. doi: 10.1007/s00586-012-2426-5.
10. Bradford DS, Tay BK, Hu SS. Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine. 1999;24:2617-2629.
11. Briard JL, Jegou D, Cauchoix J. Adult lumbar scoliosis. Spine. 1979;4:526-532.
12. DeWald CJ, Stanley T. Instrumentation-related complications of multilevel fusions for adult spinal deformity patients over age 65: surgical considerations and treatment options in patients with poor bone quality. Spine. 2006;31(19 Suppl):S144-S151.
13. Fowles JV, Drummond DS, L’Ecuyer S, et al. Untreated scoliosis in the adult. Clin Orthop Relat Res. 1978;(134):212-217.
14. Horton WC, Holt RT, Muldowny DS. Controversy. Fusion of L5-S1 in adult scoliosis. Spine. 1996;21:2520-2522.
15. Jang JS, Lee SH. Minimally invasive transforaminal lumbar interbody fusion with ipsilateral pedicle screw and contralateral facet screw fixation. J Neurosurg Spine. 2005;3:218-223.
16. Johnson JR, Holt RT. Combined use of anterior and posterior surgery for adult scoliosis. Orthop Clin North Am. 1988;19:361-370.
17. Kim YB, Lenke LG, Kim YJ, et al. The morbidity of an anterior thoracolumbar approach: adult spinal deformity patients with greater than five-year follow-up. Spine. 2009;34:822-826. doi: 10.1097/BRS.0b013e31818e3157.
18. Modic MT, Steinberg PM, Ross JS, et al. Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 1988;166:193-199.
19. Park P, Foley KT. Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years’ follow-up. Neurosurg Focus. 2008;25:E16. doi: 10.3171/FOC/2008/25/8/E16.
20. Park Y, Ha JW. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine. 2007;32:537-543.
21. Perennou D, Marcelli C, Herisson C, et al. Adult lumbar scoliosis. Epidemiologic aspects in a low-back pain population. Spine. 1994;19:123-128.
22. Schwab F, Dubey A, Gamez L, et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine. 2005;30:1082-1085.
23. Schwab F, el-Fegoun AB, Gamez L, et al. A lumbar classification of scoliosis in the adult patient: preliminary approach. Spine. 2005;30:1670-1673.
24. Shapiro GS, Taira G, Boachie-Adjei O. Results of surgical treatment of adult idiopathic scoliosis with low back pain and spinal stenosis: a study of long-term clinical radiographic outcomes. Spine. 2003;28:358-363.
25. Swank S, Lonstein JE, Moe JH, et al. Surgical treatment of adult scoliosis. A review of two hundred and twenty-two cases. J Bone Joint Surg Am. 1981;63:268-287.
26. Wang MY, Mummaneni PV. Minimally invasive surgery for thoracolumbar spinal deformity: initial clinical experience with clinical anad radiographic outcomes. Neurosurg Focus. 2010;28:E9. doi: 10.3171/2010.1.FOCUS09286.
Review
For citations:
Krutko A.V., Durny P., Vasilyev A.I., Bulatov A.V. MINIMALLY INVASIVE SURGICAL TREATMENT FOR ADULT DEGENERATIVE LUMBAR SCOLIOSIS. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2014;(4):49-56. (In Russ.) https://doi.org/10.14531/ss2014.4.49-56
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