Objective: Degenerative lumbar spine disease affects millions worldwide, substantially diminishing quality of life. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has emerged as a preferred alternative to open TLIF, offering reduced morbidity and improved cosmetic and functional outcomes. This study investigated the long-term outcomes of MIS-TLIF in patients with lumbar degenerative disease. Methods: We conducted a retrospective analysis of 180 patients who underwent MIS-TLIF between 2009 and 2014. Inclusion criteria comprised persistent back and leg pain unresponsive to conservative management, single- or double-level lumbar stenosis or spondylolisthesis, and at least 5-year follow-up. Patients with prior spinal instrumentation, trauma, or multilevel disease were excluded. All procedures were performed using tubular retractors and a microscope, with pedicle screws inserted over guidewires. Parameters assessed included estimated blood loss, operative time, hospital stay, complications, and revisions. Functional outcomes were evaluated using the visual analogue scale (VAS) and Oswestry Disability Index (ODI). Long-term complications and fusion rates were also analysed. Results: MIS-TLIF resulted in significant improvement in VAS and ODI scores at final follow-up (p<0.05). The overall complication rate was 5%, and the incidence of adjacent segment disease was 8.8%, both comparable to or better than rates reported in the literature. The technique preserved pelvic incidence and lumbar lordosis while reducing tissue injury, blood loss, and length of hospitalisation compared to open TLIF. Conclusion MIS-TLIF is a safe and effective technique for lumbar degenerative disease, offering superior long-term functional outcomes, lower complication rates, and expedited recovery in well-selected patients.

BACKGROUND: Detection of postoperative spinal cord level change can provide basic information about the spinal cord status, and electrophysiological studies regarding this point should be conducted in the future. METHODS: To determine the changes in the spinal cord level postoperatively and the possible associated factors, we prospectively studied 31 patients with scoliosis. All the patients underwent correction and posterior fusion using pedicle screws and rods between January 2008 and March 2009. The pre- and postoperative conus medullaris levels were determined by matching the axial magnetic resonance image to the sagittal scout image. The patients were divided according to the change in the postoperative conus medullaris level. The change group was defined as the patients who showed a change of more than one divided section in the vertebral column postoperatively, and the parameters of the change and non-change groups were compared. RESULTS: The mean pre- and postoperative Cobb's angle of the coronal curve was 76.80degrees +/- 17.19degrees and 33.23degrees +/- 14.39degrees, respectively. Eleven of 31 patients showed a lower conus medullaris level postoperatively. There were no differences in the pre- and postoperative magnitude of the coronal curve, lordosis and kyphosis between the groups. However, the postoperative degrees of correction of the coronal curve and lumbar lordosis were higher in the change group. There were also differences in the disease entities between the groups. A higher percentage of patients with Duchene muscular dystrophy had a change in level compared to that of the patients with cerebral palsy (83.3% vs. 45.5%, respectively). CONCLUSIONS: The conus medullaris level changed postoperatively in the patients with severe scoliosis. Overall, the postoperative degree of correction of the coronal curve was higher in the change group than that in the non-change group. The degrees of correction of the coronal curve and lumbar lordosis were related to the spinal cord level change after scoliosis correction.
Adolescent ; Adult ; Cerebral Palsy/complications ; Child ; Female ; Humans ; Kyphosis/radiography ; Lordosis/radiography ; Lumbar Vertebrae/radiography/surgery ; *Magnetic Resonance Imaging ; Male ; Muscular Dystrophy, Duchenne/complications ; Prospective Studies ; Scoliosis/complications/radiography/*surgery ; Severity of Illness Index ; Spinal Cord/*pathology ; Thoracic Vertebrae/radiography/surgery ; Young Adult

STUDY DESIGN: A retrospective study. PURPOSE: To compare outcomes of apical derotation with pedicle screws in idiopathic and neuromuscular scoliosis (NMS). OVERVIEW OF LITERATURE: No information about apical derotation in NMS with pedicle screws is available. METHODS: We performed deformity correcting surgery using pedicle screw constructs on 12 adolescent idiopathic scoliosis (AIS) patients (mean age 14.1 years) and 16 NMS patients (mean age 16.5 years). Preoperative, postoperative, and final follow-up radiographs were analyzed for Cobb's angle and pelvic obliquity, while apical rotation was measured on CT scans using the Aaro-Dahlborn method. RESULTS: For AIS, the mean preoperative Cobb's angle, pelvic obliquity, and apical rotation values were 57.3degrees, 2.8degrees, and 20.4degrees, respectively, and postoperatively they were 16.8degrees, 1.1degrees and 14.7degrees, respectively, showing significant correction. For NMS, the mean preoperative Cobb's angle, pelvic obliquity, and apical rotation values were 75.6degrees, 13.7degrees, and 42.9degrees, respectively, and postoperatively they were 27.1degrees, 5.8degrees, and 34.1degrees, respectively, also showing significant correction. There were no significant differences between AIS and NMS patients Cobb's angle p=0.306, pelvic obliquity p=0.887 and apical derotation p=0.113degrees. There were no differences in curve severity in the three groups (AIS, NMS >80degreesand NMS <80degrees); or the correction of apical rotation (p=0.25), although less correction was achieved in the Cobb's angle in the >80 NMS group (p=0.04). CONCLUSIONS: Apical axial derotation can be achieved with posterior only pedicle screw fixation in NMS without anterior release, with comparable results in idiopathic scoliosis.
Adolescent ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Retrospective Studies ; Scoliosis

STUDY DESIGN: Retrospective comparative study using radiographs and clinical findings. PURPOSE: To test the hypothesis that asymmetric loading of immature spines in young athletes initiates scoliosis. OVERVIEW OF LITERATURE: Scoliosis in athletes has been reported in the literature, but its causative factors have not been investigated. METHODS: We compared the incidence, type and magnitude of scoliotic curves in volleyball players with those in the non-player population. One hundred sixteen adolescent volleyball players were grouped for selective screening. Data regarding their playing duration, handedness, age, height, and menarchal status (in girls) were recorded, along with clinical examination and radiological investigation when necessary. We analyzed data from 46,428 non-player school children, and their data were compared to athletes to determine differences. RESULTS: Volleyball players had a statistically significant increase in the incidence of scoliotic spinal curves. Playing hand dominance was related to the curve direction. Cobb angle had no significant correlation with the duration of playing. CONCLUSIONS: There is a five-fold increase in the incidence of mild scoliosis in volleyball players. A high percentage (41%) of asymmetry was present on the Adams forward bending test, as compared to controls. The curves were either thoracic or thoracolumbar.
Adolescent ; Athletes ; Child ; Functional Laterality ; Hand ; Humans ; Incidence ; Mass Screening ; Muscles ; Retrospective Studies ; Scoliosis ; Spine ; Volleyball