Vertebral Body Rotation in Patient of Lumbar Degenerative Scoliosis; Surgical Implication for Oblique Lumbar Interbody Fusion (OLIF).

Vertebral Body Rotation in Patient of Lumbar Degenerative Scoliosis; Surgical Implication for Oblique Lumbar Interbody Fusion (OLIF).

World Neurosurg. 2018 Dec 26;:

Authors: Kim DB, Shin MH, Kim JT

Abstract
BACKGROUND: To investigate changes of oblique corridor in patients with lumbar degenerative scoliosis (LDS) and determine proper working angle with respect to the direction of vertebral axial rotation during oblique lumbar interbody fusion (OLIF) procedure.
METHODS: Distance of oblique corridor and rotational angle of the left or right apex group were measured on axial T2 MR images and then compared with those of propensity score-matched control group.
RESULTS: Fifty-five patients of the left apex group and 57 patients of the right apex group were compared with equal number of patients of the propensity score-matched control group. The distance of oblique corridor in the left apex group was shorter than that in the control group at levels of L1-2 and L2-3. In contrast, the distance of oblique corridor in the right apex group was longer than that of the control group at level of L2-3. Patients of the left apex group showed vertebral body rotating to the left side from L1-2 to L5-S1 while in the right apex group, the vertebral body rotated to the right side at level of L1-2, L2-3, and L3-4.
CONCLUSIONS: In the left apex group, the oblique corridor was decreased from psoas overlap and coupled axial rotation to the left side might increase the risk of contralateral nerve root injury during orthogonally working. Thus, surgeons should pay attention to the state of coupled vertebral axial rotation of LDS for OLIF procedure.

PMID: 30593961 [PubMed - as supplied by publisher]

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