| ObjectivesTo respectively discuss the optimal surgical methods for Andersson Lesion depending on deformity correction or not.MethodsThere may be a great difference in the surgical method for Andersson Lesion depending on deformity correction or not.To better know and cure the disease,we divided the research into two parts on the basis of deformity correction or not.The first part included clinical data of 15 cases without need of deformity correction that underwent therapies from 2004 to 2016 in Shandong Provincial Hospital.Among them,7 cases that adopted minimally invasive surgery were included as MIS group.8 cases that chose open spinal fusion were included as OSF group.Lesion curettage were not performed in both MIS and OSF groups.We took a record of the VAS scores and ODI scores in the preoperative,postoperative and last follow-up period.Operation time and blood loss during surgery were also recorded the same way.Bony fusion rate and postoperative complications were recorded.Then,we analyzed the statistical data to make a comparison about the effects of two surgical options.The second part included clinical data of 7 cases with deformity correction that underwent therapies from 2004 to 2016 in Shandong Provincial Hospital.All the cases underwent SPO therapy.We took a record of the VAS scores and ODI scores in the preoperative,postoperative and last follow-up period.Bony fusion rate and postoperative complications were recorded.At the same time,we made a record of the radiological parameters relating local kyphotic angle,SVA,TPA,PTK,TK,TLK,LL,PI,PT,SS,T1 spin angle,CBVA.At last,we analyzed the clinical and radiological data to evaluate the effects of SPO therapy.Results1.VAS score in MIS group was 5.6±1.2 preoperatively,OSF group was 5.5±0.9;No significant difference between them(P=0.895).VAS score in MIS group was 1.9±1.1 postoperatively,OSF group was 1.8±0.7;No significant difference between them(P=0.820).VAS score in MIS group was 1.8±0.7 the last follow-up,OSF group was 1.9±0.7.No significant difference between them(P=0.959)2.ODI score in MIS group was 51 ±4 preoperatively,OSF group was 52±6;No significant difference between them(P=0.775).ODI score in MIS group was 17±5 postoperatively,OSF group was 19±6;No significant difference between them(P=0.820);ODI score in MIS group was 17±5 the last follow-up,OSF group was 19±5;No significant difference between them(P=0.462).3.Operation time in MIS group was 217±127min,OSF group was 266±64min.No significant difference between them(P=0.349).Blood loss during surgery in MIS group was 174±68ml ml,OSF group was 565±162ml.There is a significant difference between them(P=0.002).4.At the final following up,non-union was observed.No instrumentation failure and neurological complication occurred in both MIS and OSF groups.There was one case with surgical site infection in OSF group.5.VAS score in SPO group was 6.0±1.2 preoperatively,1.7±0.5 postoperatively,1.4±0.5 the last follow-up.ODI score in SPO group was 53.7±6 preoperatively,14.6±4.0 postoperatively,5.1±2.0 the last follow-up.Operation time was 417±41 min and blood loss during surgery was 729±122ml.Local kyphotic angle in SPO group was 35±21°preoperatively,7±17°postoperatively,9±17°the last follow-up.SVA in SPO group was 89±30 mm preoperatively,48±27 mm postoperatively,52±31mm the last follow-up.TPA in SPO group was 35±5° preoperatively,11 ±20 postoperatively,13±2°the last follow-up.PTK in SPO group was 24±3°preoperatively,25±2° postoperatively,25±2° the last follow-up.TK in SPO group was 35±7°preoperatively,35±6° postoperatively,36±6° the last follow-up.TLK in SPO group was 39±7°preoperatively,6±2° postoperatively,7±2°the last follow-up.LL in SPO group was-6±11° preoperatively,-32±10° postoperatively,-32±10° the last follow-up.PI in SPO group was 53±6° preoperatively,53±6° postoperatively,53±4°the last follow-up.PT in SPO group was 23±9° preoperatively,17±11°postoperatively,19±8° the last follow-up.SS in SPO group was 26±7° preoperatively,3 7±14° postoperatively,34±8° the last follow-up.T1 spin angle in SPO group was 25±4° preoperatively,10±2° postoperatively,11±2° the last follow-up.CBVA in SPO group was 34±5° preoperatively,9±3° postoperatively,10±3° the last follow-up.6.The outcomes of SPO therapy have significant differences among the last follow up,postoperative and the preoperative period in terms of VAS score,ODI score,and the radiological parameters(local kyphotic angle,CBVA?SVA?TPA?LL?T1 Spin)(P<0.05).Conclusion1.MIS and OSF can exert a similar result in treating Andersson Lesion without need of deformity correction.Notably,MIS has the advantages of less blood loss,less tissue injury and fast recovery.2.VAS score and ODI score both got improved in SPO group for curing Andersson Lesion with deformity correction.Besides,the radiological paremeters relating local kyphotic angle,CBVA,SVA,TPA,LL and T1 Spin also got improved.3.It enhances the hypothesis that solid immobilization achieved by posterior instrumentation is significant in treatment for Andersson lesions.4.On the other hand,it proves the significant role of instability in the orgin and development of AL. |
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