Clinical value of oblique lateral lumbar interbody fusion combined with posterior navigation and long segment internal fixation in the treatment of degenerative scoliosis

Abstract

Background ：To assess the short-term clinical outcomes of oblique lateral lumbar interbody fusion (OLIF) combined with multiple level fixation with the guidance of posterior "O" arm CT navigation for degenerative scoliosis. Methods ：A total of 15 patients (3 males and 12 females; average age: 62.2±5.3 years) with degenerative scoliosis were enrolled in our study. All patients were treated with OLIF combined with posterior "O" arm CT navigation and long segment (T 10 -L 5 ) internal fixation during Apr. 2016 and Dec. 2017. Collected perioperative data included surgery time, blood loss, excellent rate of intraoperative pedicle screw. Coronal Cobb angle, lumbar lordosis (LL), intervertebral space height, sagittal balance (SVA) were measured by plain radiograph. Accuracy of pedicle screw placement and intervertebral fusion was investigated with postoperative CT. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the clinical efficacy of surgery. Results ： All patients were followed for 12-25 months (16.5±5.3 months).The OLIF operation time was (98.7±16.8) min, and the blood loss was (50.2±10.7) ml. The posterior "O" arm CT-navigated long segment internal fixation was (101.5 ± 23.4) min, and the blood loss was (63.1 ± 19.7) ml. The total operation time was (200.2±40.2) min, and the blood loss was (113.3±30.4) ml. Coronal Cobb angle, LL, intervertebral space height, SVA, VAS, ODI at the last follow-up were 5.5°± 3.1°, 39.3°± 9.1°, (10.9±1.2) mm, (25.1±10.9) mm, (1.3± 0.8)and(15.8±4.5)%, respectively, showing statistically significant differences ( P <0.05). The "O" arm CT navigation has 240 nails, and the excellent rate of three-dimensional scanning of the "O" arm during surgery is 96%. Lumbar CT showed lumbar fusion at the 6-month postoperative period. Conclusion ： The short-term clinical outcomes of oblique lateral lumbar interbody fusion combined with posterior "O" arm CT-navigated long segment internal fixation for degenerative scoliosis are satisfactory, with advantages like minimal invasiveness, accurate navigation, high bone fusion rate and few complications. Keywords ：Scoliosis; Surgery,computer-assisted; Spine fusion