4.5 Article

Treatment of degenerative lumbar scoliosis using transforaminal lumbar interbody fusion based on the concept of intervertebral correction

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INTERNATIONAL ORTHOPAEDICS
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SPRINGER
DOI: 10.1007/s00264-023-05774-1

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Scoliosis; Lumbar scoliosis; Correction; Decompression fusion fixation

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The study aimed to evaluate the outcomes of posterior approach transforaminal lumbar interbody fusion (TLIF) in treating degenerative lumbar scoliosis (DLS) based on the concept of intervertebral correction. A retrospective analysis was conducted on 76 surgical patients who underwent TLIF in Shenzhen Traditional Chinese Medicine Hospital. The results showed significantly improved clinical efficacy and spinal curvature parameters, suggesting that TLIF based on the concept of intervertebral correction provides favorable outcomes for the treatment of DLS.
Purpose The study aimed to examine the outcomes of posterior approach transforaminal lumbar interbody fusion (TLIF) in the treatment of degenerative lumbar scoliosis (DLS) based on the concept of intervertebral correction. Methods A retrospective analysis was performed on 76 surgical patients (36 males and 40 females) who underwent posterior TLIF and internal fixation based on the concept of intervertebral correction in Shenzhen Traditional Chinese Medicine Hospital from February 2014 to March 2021.The operation duration, intraoperative blood loss, incision length, and complications were recorded. Clinical efficacy was evaluated preoperatively and postoperative time points through the visual analog scale (VAS) and the Oswestry disability index (ODI). The changes in the coronal scoliosis curve (Cobb angle), coronal balance distance (CBD), the sagittal vertical axis (SVA), lumbar lordosis (LL), and pelvic tilt angle (PT) were assessed perioperatively at the last follow-up. Results All patients successfully underwent the operation. The average operation duration was 243.81 +/- 35.35 (220 - 350) min; the average intraoperative blood loss was 836.27 +/- 50.28 (700 - 2500) mL; the average incision length was 8.30 +/- 2.33 (8 - 15) cm. The total complication rate was 18.42% (14/76). The VAS score of low back pain, lower extremity pain, and ODI score of patients at the last follow-up was significantly improved compared with those before the operation (P < 0.05). At the last follow-up, the Cobb Angle, CBD, SVA, and PT of patients were significantly lower than those before the operation (P < 0.05), and LL was higher than those before the operation (P < 0.05). Conclusion TLIF based on the concept of intervertebral correction for the treatment of DLS may provide favourable clinical outcomes.

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