Treating Lumbar Scoliosis with Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

Abstract

Substantial evidence exists supporting lumbar fusion procedures in cases of spondylolysis, spondylolisthesis, and other cases of sagittal deformity. However, coronal deformity can also be a cause of low back and leg pain. One hundred seven patients underwent minimally invasive transforaminal lumbar interbody fusion (MITLIF). All patients had preoperative and postoperative radiographs exhibiting a clear coronal deformity that correlated with their symptomatology. Dynamic radiographs were analyzed using a three-point angle measurement tool through the EasyViz viewer program. Pre-op and post-op Cobb angles (CA) were recorded along with Health-related Quality of Life (HRQL) measures, Visual Analog Scale, Oswestry Disability Index, and SF-36. The average CA decreased from 9.47 pre-op to 7.54 post-op (p < 0.05). CA ranged from 0.7 to 43.2% pre-op, and 0.7 to 34.1% post-op. There was a statistically significant (p < 0.05) correlation between CA improvement and HRQL measure improvement. There has not been an appropriate level of focus on coronal deformity, its relationship to HRQL measures, and long-term prognosis. In our study, CA was reduced by 21% on average with just a single-level fusion, supporting the consideration of a focused single-level fusion versus a large multilevel fusion in cases of coronal deformity, especially in elderly patients.