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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Choi, Seung Won (Department of Neurosurgery, Chungnam National University Hospital) Ames, Christopher (Department of Neurosurgery, University of California San Francisco) Berven, Sigurd (Department of Orthopaedic Surgery, University of California San Francisco) Chou, Dean (Department of Neurosurgery, University of California San Francisco) Tay, Bobby (Department of Orthopaedic Surgery, University of California San Francisco) Deviren, Vedat (Department of Orthopaedic Surgery, University of California San Francisco)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제61권 제6호
발행연도
2018.1
수록면
716 - 722 (7page)

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Objective : Lateral interbody fusion (LIF) is attractive as a less invasive technique to address anterior spinal pathology in the treatment of adult spinal deformity. Its own uses and benefits in treatment of adult degenerative scoliosis are undefined. To investigate the radiographic and clinical outcomes of LIF, and staged LIF and posterior spinal fusion (PSF) for the treatment of adult degenerative scoliosis patients, we analyzed radiographic and clinical outcomes of adult degenerative scoliosis patients who underwent LIF and posterior spinal fusion. Methods : Forty consecutive adult degenerative scoliosis patients who underwent LIF followed by staged PSF at a single institution were retrospectively reviewed. Long-standing 36" anterior-posterior and lateral radiographs were taken preoperatively, at inter-stage, 3 months, 1 year, and 2 years after surgery were reviewed. Outcomes were assessed through the visual analogue scale (VAS), 36-Item Short Form Health Survey (SF-36), and Oswestry Disability Index (ODI). Results : Forty patients with a mean age of 66.3 (range, 49-79) met inclusion criteria. A mean of 3.8 levels (range, 2-5) were fused using LIF, while a mean of 9.0 levels (range, 3-16) were fused during the posterior approach. The mean time between stages was 1.4 days (range, 1-6). The mean follow-up was 19.6 months. Lumbar lordosis was significantly restored from $36.4^{\circ}$ preoperatively up to $48.9^{\circ}$ (71.4% of total correction) after LIF and $53.9^{\circ}$ after PSF. Lumbar coronal Cobb was prominently improved from $38.6^{\circ}$ preoperatively to $24.1^{\circ}$ (55.8% of total correction) after LIF, $12.6^{\circ}$ after PSF respectively. The mean pelvic incidence-lumbar lordosis mismatch was markedly improved from $22.2^{\circ}$ preoperatively to $8.1^{\circ}$ (86.5% of total correction) after LIF, $5.9^{\circ}$ after PSF. Correction of coronal imbalance and sagittal vertebral axis did not reach significance. The rate of perioperative complication was 37.5%. Five patients underwent revision surgery due to wound infection. No major perioperative medical complications occurred. At last follow-up, there were significant improvements in VAS, SF-36 Physical Component Summary and ODI scores. Conclusion : LIF provides significant corrections in the coronal and sagittal plane in the patients with adult degenerative scoliosis. However, LIF combined with staged PSF provides more excellent radiographic and clinical outcomes, with reduced perioperative risk in the treatment of adult degenerative scoliosis.
#Spine #Deformity #Fusion #Correction

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참고문헌 (29)

참고문헌 신청
Acosta FL / 2011 / 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 15:92~96 google schola Aharinejad S / 1990 / Morphometric analysis of vertebrae and intervertebral discs as a basis of disc replacement / Am J Anat 189:69~76 google schola Amin BY / 2013 / Four-level minimally invasive lateral interbody fusion for treatment of degenerative scoliosis / Neurosurg Focus 35(2 Suppl):10 google schola Anand N / 2013 / Long-term 2- to 5-year clinical and functional outcomes of minimally invasive surgery for adult scoliosis / Spine (Phila Pa 1976) 38:1566~1575 google schola Anand N / 2014 / Is circumferential minimally invasive surgery effective in the treatment of moderate adult idiopathic scoliosis? / Clin Orthop Relat Res 472:1762~1768 google schola

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