Clinical outcomes of XLIF through small incision approach versus PILF with open surgery for degenerative lumbar sco-liosis
10.3760/cma.j.issn.0253-2352.2015.09.003
- VernacularTitle:小切口XLIF与后正中入路PLIF椎弓根螺钉固定治疗退变性腰椎侧凸
- Author:
Yonggang TIAN
;
Han JIANG
;
Yi JIANG
;
Lianping XIAO
;
Tonghao WANG
;
Liqiang HAN
- Publication Type:Journal Article
- Keywords:
Scoliosis;
Spinal fusion;
Surgical procedures,minimally invasive
- From:
Chinese Journal of Orthopaedics
2015;(9):898-905
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate short?term clinical outcomes of XLIF through small incision approach combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis. Methods From December 2011 to June 2013, 15 pa?tients with degenerative lumbar scoliosis were treated by XLIF combined with percutaneous pedicle screw fixation (XLIF group). There were 6 males and 9 females, with an average age of 68.27±5.70 (ranging from 58 to 75) years old and Cobb angle of scoliosis 22.20°±6.66° (ranging from 14° to 35°). Meanwhile, 23 patients were treated with posterior lumber inter?body fusion (PLIF) com?bined with pedicle screw fixation (PLIF group). There were 9 males and 14 females, with an average age of 63.26 ± 6.03 (ranging from 49 to 73) years old and Cobb angle of scoliosis 23.17°±6.95° (ranging from 13° to 36°). The efficacy was assessed through cor?rection rate of Cobb angle, VAS and lumbar JOA score at the time of the latest follow?up. Results The operation time was 224.35 ± 51.53 min in the PLIF group and 197.47 ± 31.84 min in the XLIF group. No significant differences were found, but there was significantly difference in the intraoperative blood loss (PLIF group: 576.52 ± 227.89 ml, XLIF group: 181.33 ± 47.37 ml, t=-8.054, P<0.001). No patient accepted blood transfusion in the XLIF group, but in the PLIF group, 11 patients accepted blood transfusion. The Cobb angle, VAS and JOA score in two groups were improved compared with the preoperative. 38 patients were followed up for 12 to 32 months, with an average of 23 months. The correction rate of Cobb angle, VAS and JOA scores were 56.90%±11.51%, 87.97%±12.07%, 84.00%±5.59%in the XLIF group, and 62.88%±8.28%, 83.68%±12.33%, 84.79%±6.76%in the PLIF group. No significant differences were found between the two groups (P>0.05). Conclusion Treatment of degenerative lumbar scoliosis with XLIF through small incision approach combined with percutaneous pedicle screw fixation is a kind of safe and effective minimally invasive spine surgery with small trauma and less bleeding, and the recent surgery efficacy was close to PILF.
