Introduction: The key for the good quality of life post-operative is the pathological level determination for the Selective surgery segment. The use of TLIF for debilitating back pain in degenerative scoliosis has been studied in a few literatures.
Methods: Sixty six patients with degenerative scoliosis, (41(62.1%) female, 25(37.9%) male, average age 66.4 years old. Twenty one cases (31.8%) had BMI greater than 30 kg/m2. Forty three cases (65.2%) had lumbar scoliosis and 23 (34.8%) had thoraco-lumbar type. Thirty nine cases (59.1%) had spondylolisthesis GI, 36(54.5%) had lumbar stenosis and 5(7.6%) herniated disc. All cases operated by TLIF were retrospectively reviewed from November 2011 to April 2017. There was 43(65.2%) cases levo. scoliosis, 16(24.2%) cases dextro scoliosis, and 7(10.6%) cases levodextro scolioses. Oswestry disability index, Pain analogue scale, operative time, estimated blood loss (EBL), Cobb angle pre- and post-operative, operative complications and hospital stay (LOS) and fusion rates were analyzed.
Results: All patients underwent single level TLIF with a follow-up range from 1-6 years.. Mean operative time was 199.6 ± 36.7 minutes, mean EBL was 98.2 ml ± 45.6 ml and mean LOS was 3.6 days ± 3.1 days. Cobb angle preoperative range was 20-50 degrees, average 28 changed post-operative to 10-45 degrees, average 20 with 28.6% improvement. VAS for pain significantly decreased from 7.2 ± 1.5 preop to 2.2 ± 1 at 3 months postoperative and 3.1 ±1.1 at one year (P<0.05). The ODI mean score was 50.2 ± 11.2 preop decreased to 30.1 ± 8.3 at 3 months post-op and 18.3 ± 11.3 at one year. Complications rate was 7.6% (n=5), fusion rate was >95% at 3 and 12 months follow- up based on dynamic plain radiographs.
Conclusions: Selective MI-TLIF scoliosis segment surgery with debilitating low back pain has excellent clinical outcomes and low morbidity.
Patient Care: By improving the fusion rate and clinical outcomes in scoliosis patients as regards selective pathology.
Learning Objectives: Selective MI-TLIF scoliosis segment surgery with debilitating low back pain has excellent clinical outcomes and low morbidity.