European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Multicenter Study
Radiographic outcomes of anterior column realignment for adult sagittal plane deformity: a multicenter analysis.
Anterior column reconstruction (ACR) is a minimally invasive technique for the treatment of sagittal plane deformity. ACR uses a lateral transpsoas approach with ALL release and the application of an interbody device to achieve correction. Here, we present 1-year radiographic results from a multicenter study of adult spinal deformity (ASD) patients. ⋯ ACR successfully restores lumbar lordosis in ASD patients with sagittal imbalance. ACR results in greater segmental correction than is achieved with LLIF alone. Supplementing with posterior osteotomies allows for even greater correction. The ability to achieve the desired radiographic goals is expected to improve as technical nuances are refined and patient selection is optimized.
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Comparative Study
Comparison of clinical outcomes following minimally invasive lateral interbody fusion stratified by preoperative diagnosis.
Lumbar fusion has been shown to be effective in treating a variety of degenerative spinal conditions, though significant differences exist in the magnitude of clinical improvement across different surgical diagnoses. With modern, minimally disruptive approaches for fusion, diagnosis-specific differences in clinical improvement may be reduced. The purpose of this study is to report and compare interim clinical improvements in patients treated with XLIF for various degenerative lumbar conditions. ⋯ XLIF has been demonstrated in the current series to lead to significant improvements in clinical outcomes and high rates of MCID and SCB and reduce the discrepancy in outcomes between well accepted and technically challenging indications compared to traditional open approaches for IBF. Complication rates were low, with only one patient in the series experiencing a major complication. Further investigation with larger cohorts and longer follow-up is warranted.
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Minimal-invasive cement augmentation techniques gained popularity recently. Long-term studies, however, are still not available focusing on the effect of possible acceleration of intervertebral disc degeneration. ⋯ Despite several limitations regarding patients' age and lack of performed perfusion MRI scans, this study suggests that vertebral cement augmentation through kyphoplasty has no significant influence on disc degeneration even after a long period. The absence of severe disc degeneration after vertebral augmentation supports further clinical trials, which should incorporate endplate perfusion studies for detailed information regarding disc perfusion.
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Lateral access lumbar interbody fusion (LLIF) is a minimally invasive technique that has an increasing popularity. It offers unique advantages and circumvents risk of certain serious complications encountered in other conventional spinal approaches. This study provides a statistical analysis defining the lateral access learning curve in the Asian population. ⋯ During the learning process, there was no compromise of perioperative or clinical outcomes. It should be feasibly incorporated into a spine surgeon's repertoire of procedures for the lumbar spine.
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This study evaluated the risk factors of new vertebral compression fractures (VCFs) following percutaneous vertebroplasty (PVP). ⋯ The incidence of new symptomatic VCFs after PVP was higher in osteoporotic patients with initial multiple-level fractures.