Clinical analysis and imaging study of lateral lumbar intervertebral fusion in the treatment of degenerative lumbar scoliosis

Abstract

Abstract Background With the increase in aging populations and the progress of technology, lateral lumbar intervertebral fusion (LLIF) for the treatment of degenerative lumbar scoliosis (DLS) has been gaining more and more interest and usage. Objective To explore the feasibility and advantages of LLIF in the treatment of DLS and to observe the outcome through measurements of clinical efficacy and imaging changes. Methods A retrospective analysis was performed for 52 DLS patients (12 males and 40 females, aged 65.84 ± 9.873 years) who underwent LLIF from January 2019 to January 2023. The operation time, blood loss, complications, clinical efficacy indicators (VAS, ODI, and SF-36), and imaging indicators (coronal position: Cobb angle and CSVL-C7PL; and sagittal position: LL, SVA, PI, and TK) were measured, and follow-up was carried out for these patients. The postoperative and follow-up measurements were compared to the preoperative values. Results All patients successfully completed the operation, with an overall operation time of 283.90 ± 81.62 min, total blood loss of 257.27 ± 213.44 ml, and no serious complications. The clinical efficacy indexes after surgery and at follow-up were significantly improved compared with the preoperative period (P < 0.001). Compared to the preoperative values, the Cobb angle and LL angle were significantly improved after surgery (P < 0.001). Meanwhile, CSVL-C7PL, SVA, and TK did not change much after surgery (P > 0.05) but improved significantly at follow-up (P < 0.001). There was no significant change in PI at either the postoperative or follow-up timepoint. Conclusion LLIF showed less surgical bleeding, less trauma, and fast postoperative recovery, which can significantly restore and improve the balance of sagittal and coronal positions of the lumbar spine, and also improve the compensatory thoracic scoliosis.