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  • Correction of Degenerative Lumbar Scoliosis with Lateral Extended TLIF Technique

    Final Number:

    Authors:
    Ronald J. Sabitzer

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting

    Introduction: Degenerative lumbar scoliosis ( DLS )represents a major surgical challenge in spinal surgery for the elderly. Treatment options include anterior disc height reconstruction and scoliotic correction with posterior pedicle screw fixation. This type of surgery is associated with a high morbidity. The less invasive this type of surgery can be performed the higher the benefit for the patient is. This study presents a new technique that enables the surgeon to decompress and correct at the same time from posterior using the lateral extended TLIF ( latexTLIF )approach.

    Methods: In a consecutive series of 180 patients operated by the latexTLIF approach from 12/2014 to 12/2015 16 with severe DLS were investigated retrospectively. Measured parameters preoperative and at 6 months postoperative: VAS, ODI, walking distance, subjective state of satisfaction ( would do operation again and can recommend ) and radiologic correction of scoliotic deformity and restoration of lordosis. A novel TLIF cage, ACRON, was used that has an increased footprint compared to standard TLIF cages. Therfore it not only rests on the central weak part of the endplate.

    Results: All patients improved in clinical and radiological parameters. VAS preop mean: 8.5 - postop mean:2.5 ODI dropped postop by 25 points on average Walking distance ( in meter ) preop all patients 100 to 500m postop more than 500m Subjective state of satisfaction postop 100% Preop scoliosis: mean 33.6° ( 28.8° - 42.8° ) Postop scoliosis: mean 2.7° ( 1.0° - 3.9° ) Preop global lordosis: mean 26.7° ( 21.2° - 36.1° ) Postop global lordosis: mean 43.1° ( 37.7° - 46.1° ) Complications intraop: 1 dural tear Complicationes postop: none

    Conclusions: This modified TLIF technique - latexTLIF - showed up to effectively correct scoliotic deformity and restore lordosis significantly by a single posterior approach. Hence it can develope as an alternative to other approaches with a potential number of benefits.

    Patient Care: provide an alternativ surgical technique

    Learning Objectives: surgical strategies in DLS

    References:

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