Clinical Analysis And Imaging Evaluation Of Lateral Lumbar Interbody Fusion In The Treatment Of Adult Degenerative Scoliosis

Objective:To explore the advantages,clinical efficacy and imaging data changes of lateral lumbar interbody fusion in the treatment of adult degenerative scoliosis.Methods:From January 2019 to January 2021,20 patients with lumbar degenerative scoliosis were selected,including 10 male patients and 10 female patients,with an average age of(56.1 ± 3.4)years old ranging from 40 to 70 years old.The course of disease was12-48 months,with an average of(28 ± 6.23)months.The Cobb angle of scoliosis segment was more than 10 °in 20 patients,and all of them were treated by lateral lumbar interbody fusion(LLIF).The visual analogue scale(VAS),Oswestry disability index(ODI)and 3the MOS item short from health survey(SF-36)were used to evaluate the recovery of pain and neurological function.According to the imaging data of the patients,including lumbar lordosis angle(LL),sagittal vertical axis distance(SVA),lumbar coronal Cobb angle and other imaging measurement data,the recovery of coronal and sagittal balance of corresponding segments of degenerative scoliosis after operation was evaluated.The operation time and blood loss were recorded to evaluate the advantages of the operation.Results:Twenty patients with ADS treated by LLIF were selected.The operation data,medical records and imaging data were statistically analyzed.The operation time was130-340 min,with an average of(255 ± 36)min;the intraoperative blood loss was10-480 ml,with an average of(105 ± 16.2)ml.The average preoperative VAS score,ODI index and SF-36 score were(5.68±1.14)、(83.5±8.19)%、(70.29±6.89).The average postoperative VAS score,ODI index and SF-36 score were(2.74±0.42)、(47.11±9.54)%、(79.41±5.00)and the last follow-up data were(1.52±0.28)、(11.63±2.93)%、(111.06 ± 7.56),the difference was statistically significant(P < 0.05).The mean preoperative coronal Cobb angle,lumbar lordosis angle and sagittal vertical axis distance were(27.80±14.09)°,(36.7±15.78),and(39.80±15.99)mm respectively.The mean postoperative coronal Cobb angle,LL and SVA were(7.50±3.47)°、(46.60±14.96)°、(27.60±16.20)mm and the last follow-up data were(8.20±4.87)°、(46.10±15.50)°、(20.40±10.36)mm respectively.The postoperative imaging data were significantly recovered.Conclusion:Anterolateral lumbar interbody fusion is effective in the treatment of degenerative lumbar scoliosis,with the advantages of short operation time and less bleeding.According to the imaging data,the balance of scoliosis segment has been restored to a certain extent in both coronal and sagittal images.