Lateral lumbar interbody fusion improved outcomes in adult patients with scoliosis
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According to published results, lateral lumbar interbody fusion improved long-term functional outcomes and patient satisfaction with low revision rates for adult patients with scoliosis.
Stuart Changoor, MD, and colleagues retrospectively reviewed data on 26 patients (mean age of 62 years) who underwent lateral lumbar interbody fusion (LLIF) for adult scoliosis between 2008 and 2013 with a mean follow-up of 89 months and a mean of 1.8 levels fused per operation. Outcome measures included deformity Cobb angle measurements, pelvic incidence (PI), lumbar lordosis (LL), Oswestry Disability Index (ODI), VAS pain scores, revisions, complications and satisfaction.
Overall, four patients (15.4%) required revision – a low proportion for a treatment “with an established high rate of revision,” the researchers wrote in the study. Mean deformity Cobb angle was 26° preoperatively and 14° postoperatively. Mean PI-LL mismatch was 11.7° preoperatively and 5.9° postoperatively. Additionally, 19 patients (73%) had a PI-LL mismatch greater than 10° preoperatively, while two patients (7.7%) had a mismatch postoperatively, the researchers noted.
All functional outcomes improved preoperatively to postoperatively. After LLIF, mean VAS pain scores improved from 7.8 to 3.5 and mean ODI scores improved from 52% to 30%, according to the study.
“The ability to reduce pelvic mismatch may further reduce the rate of revision,” the researchers wrote. “As this supplemental technique garners further popularity, future research and multicenter studies should focus on comparing outcomes of particular constructs by length of fusion,” they added.
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