#275 Correction in the Sagittal Plane and Spinopelvic Parameters Following Standard Multilevel Lateral Lumbar Interbody Fusion

General Session: Lateral Interbody Fusion

Presented by: L. Pimenta

Author(s):

L. Pimenta (1), (2)
R. Jensen (1)
L. Marchi (1)
L. Oliveira (1)
C. Castro (1)
E. Coutinho (1)
T. Coutinho (1)
R. Amaral (1)

(1) Instituto de Patologia da Coluna, São Paulo, Brazil
(2) UCSD, Neurosurgery, San Diego, CA, USA

Abstract

Introduction: Regarding degenerative conditions, flat back syndrome and incongruent spinopelvic parameters may contribute to clinical symptoms and is thought to accelerate degeneration and iatrogenic deformities. Lateral interbody fusion was proven to correct coronal alignment but yet its role in sagittal reconstruction remains unclear. Here we present the correction in the sagittal plane and spinopelvic parameters following stand-alone multilevel lateral lumbar interbody fusion.

Methods: A retrospective analysis on prospective, non-randomized, single center single surgeon studies with up to six-year follow-up. 55 patients (206 spine levels) mean age 70.1 y/o (51-87, range), with multilevel degenerative disc pathologies (DDD and/or low-grade spondylolisthesis and/or low-grade deg scoliosis), but without sagittal imbalance as the primary diagnosis. Images, neurological examination and clinical outcome assessments using ODI and VAS scores were collected. Discectomy and interbody grafting were performed via retroperitoneal lateral transpsoas only. The operated levels ranged from 3 to 7 levels (mean 3.7), including T10-T11 to L4-L5.

Results: Clinical outcomes (VAS and ODI) improved significantly in the postoperative evaluations. Lumbar lordosis improved from average 37.1 at pre-op to 45.1 degrees at last follow up (P< 0.001). Sacral slope improved from average 29.8 at pre-op to 34.8 degrees at last follow up (P< 0.001), indirectly showing a pelvic tilt decrease of average 5 degrees, once SS and PT are complementary parameters (SS + PT= pelvic incidence, a fixed angle).

Conclusions: Using the lateral retroperitoneal minimal invasive approach we were able to access instability and disc based conditions, along with mild but important improvement of lumbar lordosis and spinopelvic balance.