Role of Minimally Invasive Spine Surgery in Adults with Degenerative Lumbar Scoliosis: A Narrative Review

Tannoury, Tony; Haddadi, Kaveh; Kempegowda, Harish; Kadam, Abhijeet; Tannoury, Chadi

doi:10.29252/irjns.3.2.39

Cited by 4 publications

(4 citation statements)

References 82 publications

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“…Even though the result of facetectomy is superior in axial rotation than in the bending planes, all variances are in a few tenths of a degree below this loading model. Cross-links cannot be therefore clinically supported based on these minor biomechanical alterations (Figure 2) [49][50][51][52].…”

Section: Interbody Fusion and Cross-linksmentioning

confidence: 99%

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Skipping Cross Links in Posterior Spine Surgery: A Review

Shafizad

Haddadi

2020

Iran J Neurosurg

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Background and Aim: Given the conflicting and unreliable evidence for using cross-links in posterior spine surgery, this review was conducted to highlight the different features and usefulness of these augmentation devices in spine surgeries. Methods and Materials/Patients: After searching databases using specific keywords, the relevant articles were ultimately selected and evaluated. Results: Biomechanically investigating the use of cross-links has not resulted in unanimous explanations for their effect. The site and direction of cross-links have been rarely investigated in the literature. Some studies recommended eliminating their application from clinical practice; nevertheless, these studies do not necessarily yield clinical benefits. Posterior spinal fixation with pedicle screws and without cross-links offers stability in all the planes in most clinical conditions. Conclusion: Excluding the cross-links in posterior spine surgery may shorten the operation time and reduce hospital costs. Researchers have reported other problems for cross-links such as late pain, device failure, infections, device prominence, and pseudarthrosis which may be obliterated through the avoidance of their combination in a spinal construct; nevertheless, the results of animal models of the application of special cross-links in a degenerative disorder or deformity suggest that diagonal cross-links provide the highest stability of the construct if they are matched with a rodonly system or with transverse cross-link constructs resulting in a rectangular configuration.

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Section: Interbody Fusion and Cross-linksmentioning

confidence: 99%

“…Extensive investigations showed the complications of using pedicle screw-rod systems and cross-links to be associated with the hardware and include screw backout, screw breaking, and system collapse as well as overlooking dural tears causing the cerebrospinal fluid leak, wound infections, and neurologic deficits [48][49][50].…”

Section: Complicationsmentioning

confidence: 99%

Skipping Cross Links in Posterior Spine Surgery: A Review

Shafizad

Haddadi

2020

Iran J Neurosurg

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“…Traditional surgical approaches to this disease often involve a combination of multilevel spinal decompression and vertebral fusion. Modern technological advancements in minimally invasive surgery (MIS) in conjunction with personalized patient care and appropriate patient selection have shown evidence for improved outcomes in this patient population [ 4 , 5 ]. Common MIS approaches include lateral lumbar interbody fusion (LLIF), anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF), and posterior lumbar interbody fusion (PLIF).…”

Section: Introductionmentioning

confidence: 99%

“…Common MIS approaches include lateral lumbar interbody fusion (LLIF), anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF), and posterior lumbar interbody fusion (PLIF). These MIS approaches are reported to be associated with lower complication rates and morbidity, limited soft tissue disturbance, decreased blood loss, improved cosmesis, shorter hospital stays, and earlier return to work [5][6][7][8]. The use of dual expandable cages with percutaneous pedicle screw (PPS) placement in MIS spine surgery has been recently reported in the literature to provide restoration of intervertebral disc space height and alignment through a narrow operative window [7] but robust clinical data is lacking.…”

Section: Introductionmentioning

confidence: 99%

Utilization of Dual Expandable Cages in Lateral Lumbar Interbody Fusion Surgery

Omosor,

Edelbach,

Amer

et al. 2023

Cureus

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The aim of this study is to present a case series of adult patients with lumbar degenerative scoliosis who underwent focused minimally invasive spine (MIS) surgery utilizing a new dual expandable cage technology. The study investigates the effectiveness of this approach in reducing the symptoms and progression of lumbar degenerative scoliosis (LDS). Adult patients with lumbar degenerative scoliosis were selected for focused MIS using the newly introduced expandable cage technology. Patient demographics, preoperative evaluations, surgical details, and postoperative outcomes were recorded. The primary outcome measures included the restoration of disc space height, an improvement in clinical outcomes, and a reduction in surgical complications. Analysis of the case series reveals promising outcomes following focused MIS with the utilization of the new expandable cage technology. The technique demonstrated successful restoration of intervertebral disc space heights and improved clinical outcomes in patients with lumbar degenerative scoliosis. Furthermore, a notable reduction in surgical complications was observed. The findings from this case series suggest that MIS with the implementation of the new expandable cage technology holds promise for patients with lumbar degenerative scoliosis. This approach appears to have the potential to effectively restore disc space heights, improve clinical outcomes, and minimize surgical complications. Here, we want to emphasize and add details to the improved clinical outcomes of this technology; however, further research and larger prospective studies are warranted to validate these preliminary results and establish the long-term benefits and safety profile of this innovative technique.

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Complications Associated With Minimally Invasive Anterior to the Psoas (ATP) Fusion of the Lumbosacral Spine

Tannoury

Kempegowda

Haddadi

et al. 2019

Spine

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Study Design. Retrospective cohort study. Objectives. To analyze complications associated with minimally invasive anterolateral retroperitoneal antepsoas lumbosacral fusion (MIS-ATP). Summary of Background Data. MIS-ATP provides anterolateral access to the lumbar spine allowing for safe anterior lumbar interbody fusions between T12-S1. Anecdotally, many surgeons believe that ATP approach is not feasible at L5-S1 level, predisposing to catastrophic vascular injuries. This approach may help overcome limitations associated with conventional straight anterior lumbar interbody fusions, MIS lateral lumbar interbody fusion, and oblique lateral interbody fusion. Methods. A detailed retrospective chart review of patients who had underwent MIS-ATP approach for lumbar fusion between T12-S1 was performed. Available electronic data from surgeries performed between January 2008 and March 2017 was carefully screened for surgical patients treated for spondylolisthesis, spondylosis, stenosis, sagittal, and/or coronal deformity. Detailed review of electronic medical records including operative notes, progress notes, discharge summaries, laboratory results, imaging reports, and clinic visit notes performed by a single independent reviewer not involved in patient care for documented complications. A complication is defined as any adverse event related to the index spine procedure for which patient required specific intervention or treatment. Results. Nine hundred forty patients with a total of 2429 interbody fusion levels performed via MIS-ATP were identified during the study period. Sixty-seven patients (7.2%) sustained one or more complications during the perioperative period, of which 25.5% were surgical and 74.5% were medical. Overall, 78 (8.2%) surgical complications pertaining to the index procedure were noted during a postoperative period of 1 year from the date of surgery. No major vascular or direct visceral injuries were encountered. Conclusions. MIS-ATP approach provides a safe access to anterolateral interbody fusions between T12-S1. The ATP approach is performed by the spine surgeon, does not require neuromonitoring, and warrants minimal to no psoas muscle retraction resulting in significantly reduced postoperative thigh pain and rare neurologic injuries. Additionally, the direct and clear visualization of the retroperitoneal vasculature provided by the ATP approach minimizes the risk of inadvertent vascular injury. Level of Evidence: 4

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Role of Minimally Invasive Spine Surgery in Adults with Degenerative Lumbar Scoliosis: A Narrative Review

Cited by 4 publications

References 82 publications

Skipping Cross Links in Posterior Spine Surgery: A Review

Skipping Cross Links in Posterior Spine Surgery: A Review

Utilization of Dual Expandable Cages in Lateral Lumbar Interbody Fusion Surgery

Complications Associated With Minimally Invasive Anterior to the Psoas (ATP) Fusion of the Lumbosacral Spine

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