Comparison of complications and clinical outcomes between extreme lateral/posterior and open anterior/posterior approaches in the treatment of adult scoliosis

作者：Honglei; YI; Jiawei; LIAO; Oheneba; Bo...scoliosisspinalfusionextremelateralinterbodyanteroposteriorpostoperativecomplicationsadult

摘要：Objectives To determine the differences of clinical outcome and complications between combined extreme lateral/posterior(X/P)approach and open anterior/posterior(A/P)approach for treatment of adult scoliosis.Methods Twelve patients who had X/P fusion for primary adult scoliosis were matched with a cohort of 18 patients who underwent A/P treatment.Open anterior fusion was performed via a thoracotomy/thoracoabdominal approach,and extreme lateral interbody fusion(XLIF)was performed using an expandable tubular retractor through a transpsoas access to the target disc space.All of the patients were followed up at least 2 years.Operating time,estimate blood loss(EBL)and transfusion volume were noted,radiographic parameters were evaluated before surgery and at final follow-up,and Scoliosis Research Society(SRS)-22 score,Oswestry disability index(ODI)as well as complications were recorded.Results There were no significant differences between two groups for age,gender,diagnosis,preoperative curve magnitudes and fusion levels.EBL was statistically less in X/P than A/P group(2 304 vs 3 176 mL,P=0.04),and there was a trend toward shorter surgical time(493 vs 528 min,P=0.057).Postoperative radiographic coronal correction were almost the same between two groups.There were 14 complications including 4 perioperative and 10 late in X/P group,comparing to A/P group with 11 perioperative and 12 late complications,which showed no significant differences between two groups(P>0.05).Wound infection was found in 3 A/P patients while no X/P patients was infected(P=0.26).Early revision surgery was performed in 0 X/P patients and 3 A/P patients without significant difference(P=0.26).Pseudarthrosis rates found in X/P versus A/P group(3/12 vs 1/18)were not significantly different(P=0.27).The occurrence rate of proximal junctional kyphosis(PJK)was the same(5/12 vs 7/18)in two groups.SRS-22 score and ODI in two groups reflected a similar patient assessment before surgery,and improvement at the last follow-up.Conclusions Combined X/P approach su

注：因版权方要求，不能公开全文，如需全文，请咨询杂志社