Short-term outcomes and surgical tips on circumferential MIS using LIF and PPS for adult idiopathic scoliosis

• Published in: Journal of Spine Research Vol. 12; no. 7; pp. 952 - 957
• Main Authors: Paku, Masaaki, Ishihara, Masayuki, Ando, Muneharu, Taniguchi, Shinichiro, Adachi, Takashi, Saito, Takanori, Tani, Yoichi, Kushida, Taketoshi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Spine Surgery and Related Research 20.07.2021; 一般社団法人 日本脊椎脊髄病学会
• Subjects: adult idiopathic scoliosis; LIF; PPS; 側方経路椎体間固定術; 思春期特発性側弯症遺残脊柱変形; 経皮的椎弓根スクリュー
• ISSN: 1884-7137; 2435-1563
• DOI: 10.34371/jspineres.2021-0709

Purpose: The aim of this study was to examine the short-term results of circumferential minimally invasive surgery (cMIS) using lateral interbody fusion (LIF) and percutaneous pedicle screw (PPS) in the treatment of spinal deformities in patients with adult idiopathic scoliosis (AS).Subjects and methods: The study subjects were six patients with AS (five females and one male) who had undergone c-MIS using LIF and PPS between 2018 and 2019, and were followed up for more than 18 months. The parameters examined included the number of fixed vertebral bodies, upper instrumented vertebra (UIV), lower instrumented vertebra (LIV), number of LIF, average volume of blood lost, operation time, various spinopelvic parameters, pre- and postoperative Oswestry Disability Index (ODI), and perioperative complications.Results: The UIV was T4, T7, and T9 in two cases. The LIV was the pelvis in all cases. The average numbers of fixed vertebral bodies and LIF were 13.3 and 4.5, respectively. The average volume of blood lost and operation time were 723 ml and 352 min, respectively. The spinal pelvic parameters improved (lumbar lordosis (LL), 11° preoperatively vs. 50° postoperatively; pelvic incidence (PI) -LL, 39° preoperatively vs. 0° postoperatively; pelvic tilt (PT), 32° preoperatively vs. 15° postoperatively; thoracic kyphosis (TK), 19° preoperatively vs. 40° postoperatively; Cobb angle (CA), 66° preoperatively vs. 25° postoperatively; C7 central sacrum vertical line (C7CSVL), 52 mm preoperatively vs. 7 mm postoperatively; and sagittal vertical axis (SVA), 128 mm preoperatively vs. 25 mm finally). The ODI score improved from 51 to 26. Two months after the operation, the S2AI set screw was removed in one patient. The other patients had no complications.Conclusion: cMIS is a minimally invasive surgical procedure for the treatment of AS that achieves good correction and suitable short-term results. Even if cMIS is performed without posterior osteotomy, sufficient correction is possible as it corrects the balance of the coronal and sagittal planes without complete correction of scoliosis.