Abstract
Background: Osteotomies aimed at correcting adult spinal deformity are associated with higher complications and perioperative morbidity. Recently, oblique lumbar interbody fusion (OLIF) was introduced for degenerative lumbar diseases. The aim of our study is to demonstrate the effectiveness of OLIF on the management of adult degenerative lumbar deformity (ADLD). Materials and Methods: Patients with ADLD who underwent deformity correction and decompression using OLIF and posterior instrumentation were enrolled. For radiologic evaluation, Cobb's angle (CA), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were evaluated. Visual analog scale (VAS), Oswestry disability index (ODI), and perioperative parameters were recorded for clinical evaluation. Results: Fifteen patients with a mean age of 67 years (63-74 years) were enrolled prospectively and an average of 3 OLIFs (range 1-4) was performed. Posterior instrumentations were done at average of six levels (range 4-8). The mean operative blood loss was 863 ml (range 500-1400 ml) with a mean surgical duration of 7 h (range 3-11 h). SVA, TK, LL, CA, PT, and SS showed significant correction (P < 0.05) in immediate postoperative period and all parameters except TK were maintained at final followup. At the end of 24 months of average followup, 86% (13/15) showed fusion. VAS (leg pain), VAS (back pain), and ODI improved by 74% (range 40-100), 58% (range 20%-80%), and 69.5% (range 4%-90%), respectively. There were two major complications requiring revision (1 infection and 1 adjacent vertebral body fracture). Transient hip weakness present in two patients (13%) recovered within 6 weeks. Conclusions: OLIF gives favorable short term clinical and radiological outcomes in patients of ADLD. It could potentially reduce the need for morbid pelvic fixation and posterior osteotomies in patients with degenerative lumbar deformity.
| Original language | English |
|---|---|
| Pages (from-to) | 502-509 |
| Number of pages | 8 |
| Journal | Indian Journal of Orthopaedics |
| Volume | 53 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2019 Jul 1 |
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Keywords
- Adult deformity
- degenerative lumbar deformity
- degenerative lumbar kyphoscoliosis
- oblique lateral interbody fusion
- spine
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
Cite this
The radiologic and clinical outcomes of oblique lateral interbody fusion for correction of adult degenerative lumbar deformity. / Patel, Ravish Shammi; Suh, Seung-Woo; Kang, Seong Hyun; Nam, Ki Youl; Siddiqui, Shiblee Sabir; Chang, Dong Gune; Yang, Jae.
In: Indian Journal of Orthopaedics, Vol. 53, No. 4, 01.07.2019, p. 502-509.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The radiologic and clinical outcomes of oblique lateral interbody fusion for correction of adult degenerative lumbar deformity
AU - Patel, Ravish Shammi
AU - Suh, Seung-Woo
AU - Kang, Seong Hyun
AU - Nam, Ki Youl
AU - Siddiqui, Shiblee Sabir
AU - Chang, Dong Gune
AU - Yang, Jae
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background: Osteotomies aimed at correcting adult spinal deformity are associated with higher complications and perioperative morbidity. Recently, oblique lumbar interbody fusion (OLIF) was introduced for degenerative lumbar diseases. The aim of our study is to demonstrate the effectiveness of OLIF on the management of adult degenerative lumbar deformity (ADLD). Materials and Methods: Patients with ADLD who underwent deformity correction and decompression using OLIF and posterior instrumentation were enrolled. For radiologic evaluation, Cobb's angle (CA), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were evaluated. Visual analog scale (VAS), Oswestry disability index (ODI), and perioperative parameters were recorded for clinical evaluation. Results: Fifteen patients with a mean age of 67 years (63-74 years) were enrolled prospectively and an average of 3 OLIFs (range 1-4) was performed. Posterior instrumentations were done at average of six levels (range 4-8). The mean operative blood loss was 863 ml (range 500-1400 ml) with a mean surgical duration of 7 h (range 3-11 h). SVA, TK, LL, CA, PT, and SS showed significant correction (P < 0.05) in immediate postoperative period and all parameters except TK were maintained at final followup. At the end of 24 months of average followup, 86% (13/15) showed fusion. VAS (leg pain), VAS (back pain), and ODI improved by 74% (range 40-100), 58% (range 20%-80%), and 69.5% (range 4%-90%), respectively. There were two major complications requiring revision (1 infection and 1 adjacent vertebral body fracture). Transient hip weakness present in two patients (13%) recovered within 6 weeks. Conclusions: OLIF gives favorable short term clinical and radiological outcomes in patients of ADLD. It could potentially reduce the need for morbid pelvic fixation and posterior osteotomies in patients with degenerative lumbar deformity.
AB - Background: Osteotomies aimed at correcting adult spinal deformity are associated with higher complications and perioperative morbidity. Recently, oblique lumbar interbody fusion (OLIF) was introduced for degenerative lumbar diseases. The aim of our study is to demonstrate the effectiveness of OLIF on the management of adult degenerative lumbar deformity (ADLD). Materials and Methods: Patients with ADLD who underwent deformity correction and decompression using OLIF and posterior instrumentation were enrolled. For radiologic evaluation, Cobb's angle (CA), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were evaluated. Visual analog scale (VAS), Oswestry disability index (ODI), and perioperative parameters were recorded for clinical evaluation. Results: Fifteen patients with a mean age of 67 years (63-74 years) were enrolled prospectively and an average of 3 OLIFs (range 1-4) was performed. Posterior instrumentations were done at average of six levels (range 4-8). The mean operative blood loss was 863 ml (range 500-1400 ml) with a mean surgical duration of 7 h (range 3-11 h). SVA, TK, LL, CA, PT, and SS showed significant correction (P < 0.05) in immediate postoperative period and all parameters except TK were maintained at final followup. At the end of 24 months of average followup, 86% (13/15) showed fusion. VAS (leg pain), VAS (back pain), and ODI improved by 74% (range 40-100), 58% (range 20%-80%), and 69.5% (range 4%-90%), respectively. There were two major complications requiring revision (1 infection and 1 adjacent vertebral body fracture). Transient hip weakness present in two patients (13%) recovered within 6 weeks. Conclusions: OLIF gives favorable short term clinical and radiological outcomes in patients of ADLD. It could potentially reduce the need for morbid pelvic fixation and posterior osteotomies in patients with degenerative lumbar deformity.
KW - Adult deformity
KW - degenerative lumbar deformity
KW - degenerative lumbar kyphoscoliosis
KW - oblique lateral interbody fusion
KW - spine
UR - http://www.scopus.com/inward/record.url?scp=85067602944&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067602944&partnerID=8YFLogxK
U2 - 10.4103/ortho.IJOrtho_655_17
DO - 10.4103/ortho.IJOrtho_655_17
M3 - Article
AN - SCOPUS:85067602944
VL - 53
SP - 502
EP - 509
JO - Indian Journal of Orthopaedics
JF - Indian Journal of Orthopaedics
SN - 0019-5413
IS - 4
ER -