| Objective:To investigate the early clinical efficacy and radiological outcomes results of stand-alone oblique lateral interbody fusion(OLIF)in the treatment of adult degenerative scoliosis(ADS)method:Retrospective study from July 2017 to September 2018,30 patients with ADS had been surgically treated.13 males and 17 females were enrolled with ages from 35 to 83(average 64.5±10.8 year).Lumbar X-ray of all patients showed Cobb angles>10°.All 30 patients underwent stand-alone OLIF.The operation time,intraoperative blood loss,blood transfusion,length of hospital stay,and postoperative and intraoperative complications were recorded in all patients.The radiological outcomes used the Cobb angle,pelvic tilt(PT),pelvic incidence(PI);lumbar lordosis(LL),sacral slope(SS)Disc Height(DH),Clinical evaluations were performed with Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI),Coronal and sagittal balance and fusion of bone graft were evaluated at the last follow-up.Results:All the 30 patients completed the operation successfully,underwent stand-alone OLIF surgery in 44 segments;one level 16 cases,two levels 14 cases;The average operation time was(96.80±29.42)min.The average blood loss during the operation was(48.67±9.37)ml,and no blood was transfused in all patients.The average number of hospital stays(9.37±2.88)days.The average follow-up time was(19.30±4.19)mo.The Cobb angle,PT,PI,SS,and DH of the scoliosis immediately after surgery were significantly corrected compared with those before surgery,and were maintained at the last follow-up,However,the last follow-up DH was less than the postoperative follow-up.The Cobb Angle of scoliosis was 14.96±3.69° before operation,7.222±3.10° after operation,and 7.15±13.25° during the last follow-up.PT was 25.10±6.94 0 before surgery,18.88±6.03° after surgery,and 19.20±5.70° during the last follow-up.The mean value of PI was(51.23±8.21)° before operation,(52.747±7.54)° after operation,and(53.53±7.56)° during the last follow-up.The mean value of SS was 26.50±8.13° before the operation,33.91±7.97 ° after the operation,and 34.33±7.42° during the last follow-up.LL averaged 32.24±11.33° before surgery,40.33±11.77° after surgery,and 40.68±11.03° during the last follow-up.The mean value of DH was(0.72±0.27)cm before surgery,(1.24±0.21)cm after surgery,and(1.14±0.20)cm at the last follow-up.Among the 30 patients,28(93.33%)had more new bone formation in the intervertebral space,achieving bone fusion.At the last follow-up,VAS score(2.33±0.60 points)and ODI index(12.80±2.38 points)of the 30 patients were significantly lower than VAS score(5.27±0.64 points)and ODI index(29.90±6.77 points)before surgery,the difference was statistically significant(P<0.01),and the symptoms of lower back pain were significantly relieved.Intraoperative vascular injury occurred in 1 patient,postoperative fusion sink in 5 patients,and anterolateral pain in the left thigh after operation in 2 patients.No serious adverse consequences were caused after the corresponding treatment.Conclusion:The early efficacy of stand-alone OLIF in the treatment of ADS is worthy of recognition,and it provides a safe and effective treatment plan for the treatment of ADS.However,long-term effects need to be followed up to evaluate. |
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