Minimally Invasive Multilevel Percutaneous Correction and Fusion for Adult Lumbar Degenerative Scoliosis

Anand, Neel; Baron, Eli M.; Thaiyananthan, Gowriharan; Khalsa, Kunwar; Goldstein, Theodore B.

doi:10.1097/bsd.0b013e318167b06b

Cited by 259 publications

(179 citation statements)

References 32 publications

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“…The rationale for using such a percutaneous, minimally invasive fusion technique, is clearly to expand fusion indications for different patient populations [12], including elderly with grave co-morbidities and a high operative risk with conventional techniques [13]; and patients with deformities who suffer from imbalance or dislocations and are not fit for conventional, state-of-the-art, extensive anterior and posterior fusion [14][15][16]. Also, in younger patients with no anaesthesiologic contra-indications, the acceptability level of postoperative pain and a long hospital stay precludes the realization of conventional surgery in favour of the minimally invasive, same-day operation [17,18].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous endoscopic transforaminal lumbar interbody fusion: is it worth it?

Jacquot

Gastambide²

2013

International Orthopaedics (SICOT)

112

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Purpose Interbody spine fusion with cages was first described by Bagby and has been performed for a long time now in a variety of different conditions. We developed a percutaneous endoscopic lumbar fusion technique based on the principles of Kambin and an original titanium cage. Materials and methods From 2004 to 2010, 57 patients were operated on, 17 patients were male with a mean age of 50.29 years (range 34-71 years) and 40 were female with a mean age of 57.42 years (29-90 years). Nineteen patients had a previous operation. Patients were operated on under local anaesthesia in the prone position under image intensifier and a transforaminal percutaneous endoscopic approach. Results Fifty cases had a bilateral cage through a bilateral endoscopic approach, and seven cases had a unilateral endoscopic approach only; of those, three cases had only one cage. Eleven patients had a contemporary posterior plate fixation at the same time of the endoscopic cage fusion. Eight patients had a postoperative radicular pain with paresthesias. Asymptomatic migration of the cages occurred in two cases and symptomatic migration requiring a conventional secondary reoperation in 13 cases after a mean delay of eight months (range three to 36 months). The mean ODI after two years or more was 34.3 % (initial ODI 69.4 %). Conclusions The technique was introduced in our practice to take care of difficult or grave co-morbidity patients, and some patients had excellent lasting results following a very short procedure and hospital stay. However, given the 36 % complication rate in this series, we do not recommend it unless decisive technical improvements are made.

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Section: Discussionmentioning

confidence: 99%

Percutaneous endoscopic transforaminal lumbar interbody fusion: is it worth it?

Jacquot

Gastambide²

2013

International Orthopaedics (SICOT)

112

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“…In recent years, a minimally disruptive lateral transpsoas retroperitoneal technique to accomplish interbody fusion has been developed as an alternative approach to avoid the morbidity of traditional open surgery [2,29]; proof-ofconcept has been established even in elderly and obese patients [32,33]. This approach, also called lateral lumbar interbody fusion, is mostly utilized with posterior supplementation but can be used as a stand-alone anterior construction since it preserves the anterior longitudinal ligament [24], avoiding disruption of posterior stabilizing structures, permitting insertion of a large interbody graft, and restoring foraminal height with a larger surface area for arthrodesis [23,24,27].…”

Section: Introductionmentioning

confidence: 99%

Is the Lateral Transpsoas Approach Feasible for the Treatment of Adult Degenerative Scoliosis?

Castro

Oliveira

Amaral

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Lumbar degenerative scoliosis is a common condition in the elderly. Open traditional surgical approaches are associated with high-morbidity complication rates. Less invasive options may carry fewer risks in this patient population. A minimally disruptive lateral transpsoas retroperitoneal technique to accomplish interbody fusion was developed to avoid the morbidity of traditional open surgery, but this approach as an anterior stand-alone construction has not been reported yet for the treatment of adult degenerative scoliosis.Questions/purposes We determined (1) the clinical outcomes (VAS scores for back and leg, Oswestry Disability Index), (2) the radiographic outcomes (Cobb angle, lumbar lordosis, sacral slope, high-grade subsidence, osseous fusion), and (3) the reoperation and complication rates in an older population undergoing this surgical approach. Methods Between 2004 and 2008, 62 patients were treated surgically for adult degenerative scoliosis, of whom 46 (74%) were treated with stand-alone lateral lumbar interbody fusion; 11 of these (24%) were lost to followup before 24 months, leaving the records of 35 patients (nine men, 26 women; mean ± SD age, 68 ± 10 years) available for this retrospective review. General indications for this approach included neurogenic claudication and radicular symptoms with history of chronic low-back pain. A total of 107 levels were treated (mean, three; range, one to seven). Clinical and radiographic outcomes were assessed at a followup of 24 months.

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“…Além disso, facilitam a mobilização precoce e diminuem a dor pós-operatória com limitação do consumo de analgésicos, permitindo reduzir o tempo de internamento 7 . Na única série que descreve a utilização de técnicas minimamente invasivas no tratamento da escoliose lombar degenerativa em vários níveis, Anand et al 8,9 documentam o benefício da abordagem minimamente invasiva por meio de uma menor lesão tecidual e da redução das perdas hemorrágicas, sem prejuízo da eficácia terapêutica comparativamente às técnicas abertas tradicionais. Por sua vez, Ringel et al 10 relatam a segurança da fixação transpedicular por técnica percutânea na coluna lombar e torácica, mantendo um elevado nível de precisão no posicionamento dos parafusos pediculares.…”

Section: Discussionunclassified

Correcção de escoliose lombar degenerativa por técnica minimamente invasiva

Silva

Carvalho

et al. 2012

Coluna/Columna

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RESUMOA terapêutica cirúrgica da escoliose degenerativa consiste habitualmente em instrumentações e fusões mais ou menos extensas e associa-se a morbilidade significativa. A evolução tecnológica tem aberto caminho a técnicas menos invasivas que permitem obter resultados sobreponíveis aos das técnicas tradicionais minimizando a agressão cirúrgica. Descreve-se o caso de uma paciente do sexo feminino, de 63 anos, submetida a descompressão lombar posterior, em Janeiro de 2009, por alterações degenerativas marcadas. Poucos meses após a cirurgia a paciente referiu aumento das lombalgias e ciatalgia direita. O estudo imagiológico demonstrou agravamento de escoliose degenerativa L2-L5 associada a extrusão discal L2-L3 direita calcificada, fractura bilateral dos pedículos de L3 e espondilolistese degenerativa grau 1 L5-S1. Foi submetida a reintervenção cirúrgica por técnica minimamente invasiva consistindo em TLIF's L2-L3, L3-L4, L4-L5 e L5-S1 e fixação transpedicular L2-S1 bilateral, com correcção da deformidade no plano sagital e coronal. O caso clínico apresentado ilustra o potencial das abordagens minimamente invasivas no tratamento cirúrgico de escolioses degenerativas, devendo ser uma opção sempre presente considerando os benefícios potenciais para o paciente.Descritores: Escoliose/cirurgia; Procedimentos cirúrgicos minimamente invasivos; Relatos de casos. ABSTRACT Surgical treatment of degenerative scoliosis usually consists of more or less extensive instrumentation and fusion and is associated

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Minimally Invasive Multilevel Percutaneous Correction and Fusion for Adult Lumbar Degenerative Scoliosis

Abstract: A combination of 3 MIS techniques allows for correction of lumbar degenerative scoliosis. Multisegment correction can be performed with less blood loss and morbidity than for open correction.

Cited by 259 publications

References 32 publications

Percutaneous endoscopic transforaminal lumbar interbody fusion: is it worth it?

Percutaneous endoscopic transforaminal lumbar interbody fusion: is it worth it?

Is the Lateral Transpsoas Approach Feasible for the Treatment of Adult Degenerative Scoliosis?

Correcção de escoliose lombar degenerativa por técnica minimamente invasiva

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