TY - JOUR
T1 - Adult spinal deformity
T2 - effectiveness of interbody lordotic cages to restore disc angle and spino-pelvic parameters through completely mini-invasive trans-psoas and hybrid approach
AU - Barone, Giuseppe
AU - Scaramuzzo, Laura
AU - Zagra, Antonino
AU - Giudici, Fabrizio
AU - Perna, Andrea
AU - Proietti, Luca
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Purpose: The aim of the study is to assess and quantify the effectiveness of interbody lordotic cages applied by trans-psoas approach to improve radiographic parameters, showing the differences between completely mini-invasive and hybrid approach. Methods: We collected data of 65 patients affected by degenerative lumbar deformity/diseases and underwent mini-invasive lateral interbody fusion followed by percutaneous (group A, completely mini-invasive) or open (group B, hybrid) posterior instrumentation. A subgroup underwent anterior column realignment (ACR). We assessed statistical differences in preoperative and postoperative (at least 6-month) coronal and sagittal parameters, and disc angle (DA) at each level of cage application. Results: 107 lordotic cages were implanted. Group B had the most significant mean changes, especially in coronal Cobb angle, sagittal vertical axis, lumbar lordosis (LL), pelvic incidence-LL mismatch and DA. Concerning DA, at each level of lordotic cage application, in group A changed from −2.9° preop to −6.5° postop (p = 0.01); in group B, DA changed from −2.6° to −9.5° (p = 0.002) and from +1° to −13.2° in patients underwent ACR. Conclusions: Minimally invasive lateral lumbar interbody fusion is an effective technique in improving sagittal parameters. When combined with posterior open approach and/or application of ACR procedure greater corrections are possible.
AB - Purpose: The aim of the study is to assess and quantify the effectiveness of interbody lordotic cages applied by trans-psoas approach to improve radiographic parameters, showing the differences between completely mini-invasive and hybrid approach. Methods: We collected data of 65 patients affected by degenerative lumbar deformity/diseases and underwent mini-invasive lateral interbody fusion followed by percutaneous (group A, completely mini-invasive) or open (group B, hybrid) posterior instrumentation. A subgroup underwent anterior column realignment (ACR). We assessed statistical differences in preoperative and postoperative (at least 6-month) coronal and sagittal parameters, and disc angle (DA) at each level of cage application. Results: 107 lordotic cages were implanted. Group B had the most significant mean changes, especially in coronal Cobb angle, sagittal vertical axis, lumbar lordosis (LL), pelvic incidence-LL mismatch and DA. Concerning DA, at each level of lordotic cage application, in group A changed from −2.9° preop to −6.5° postop (p = 0.01); in group B, DA changed from −2.6° to −9.5° (p = 0.002) and from +1° to −13.2° in patients underwent ACR. Conclusions: Minimally invasive lateral lumbar interbody fusion is an effective technique in improving sagittal parameters. When combined with posterior open approach and/or application of ACR procedure greater corrections are possible.
KW - Adult spinal deformity
KW - Lateral trans-psoas interbody fusion
KW - Lordotic cages
KW - Spino-pelvic parameters
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U2 - 10.1007/s00586-017-5136-1
DO - 10.1007/s00586-017-5136-1
M3 - Article
AN - SCOPUS:85019557467
VL - 26
SP - 457
EP - 463
JO - European Spine Journal
JF - European Spine Journal
SN - 0940-6719
ER -