ArticleNorth American Spine Society journal2021
Short-segment minimally disruptive anterior column release for focal sagittal deformity correction of the thoracolumbar spine.
Article in North American Spine Society journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 3 citations in OpenAlex.
- Lateral lumbar and thoracic interbody fusion (LLIF) for thoracolumbar spine trauma (Trauma LLIF): A single-center, retrospective observational cohort study.North American Spine Society journal · 2024Article
- Moderate sagittal plane deformity patients have similar radiographic and functional outcomes with either anterior or posterior surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
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Authors and funding
4 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSagittal malalignment is associated with poor quality of life. Correction of lumbar lordosis through anterior column release (ACR) has been shown to improve overall sagittal alignment, however typically in combination with long posterior constructs and associated morbidity. The technical feasibility and radiographic outcomes of short-segment anterior or lateral minimally invasive surgery (MIS) ACR techniques in moderate to severe lumbar sagittal deformity were evaluated.
methodsConsecutive patients treated with short-segment MIS ACR techniques for moderate to severe lumbar sagittal deformity correction were retrospectively analyzed from a prospectively collected database. Clinical outcomes included perioperative measures of invasiveness, including operative time, blood loss, complications, and average length of stay. Radiographic outcomes included measurement of preoperative, immediate postoperative, and long-term follow-up radiographic parameters including coronal Cobb angle, lumbar lordosis (LL), pelvic incidence (PI), PI-LL mismatch, pelvic tilt (PT), T1 pelvic angle (TPA), T1 spino-pelvic inclination (T1SPI), proximal junctional angle (PJA), and sagittal vertical axis (SVA).
resultsThe cohort included 34 patients (mean age 63) who were treated at an average 2.5 interbody levels (range 1-4) through a lateral or anterior approach (LLIF or ALIF). Of 89 total interbody levels treated, 63 (71%) were ACR levels. Posterior fixation was across an average of 3.2 levels (range 1-5). Mean total operative time and blood loss were 362 minutes and 621 mL. Surgical complications occurred in 2 (5.9%). Average hospital stay was 5.5 days (including staging). At last follow-up (average 25.4 months; range 0.5-7 years), all patients (100%) demonstrated successful achievement of one or more alignment goal, with significant improvements in coronal Cobb, LL, PI-LL mismatch, PT, and TPA. No patient was revised for PJK.
conclusionsThese data show that short-segment MIS ACR correction of moderate to severe lumbar sagittal deformity is feasible and effective at achieving overall alignment goals with low procedural morbidity and risk of proximal junctional issues.
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