TY - JOUR
T1 - Minimally invasive anterolateral approaches for the treatment of back pain and adult degenerative deformity
AU - Benglis, David M.
AU - Elhammady, Mohamed Samy
AU - Levi, Allan D.
AU - Vanni, Steven
PY - 2008/9/1
Y1 - 2008/9/1
N2 - MINIMALLY INVASIVE AND interbody and instrumented fusion techniques are increasingly being used for the treatment of adult degenerative disc disease, stenosis, and deformity of the lumbar spine. Advocates of minimal access spinal approaches list certain advantages over open procedures, including decreased postoperative pain and narcotic requirements, shorter hospital stays, less blood loss, and smaller incisions. The minimally invasive anterolateral approach allows access to the lumbar spine through the retroperitoneal space. We report on the short-term clinical and radiographic outcomes in four patients with mid to high lumbar coronal deformities treated at our institution with the anterolateral transpsoas minimally invasive approach. The primary presentation of these patients was back and leg pain. All patients showed improvement in their preoperative symptoms and solid arthrodesis at 6 months. Independent nonbiased patient pain analysis was also performed. Mean follow-up was 10 months (standard deviation, 1.4 mo), and mean hospital stay was 3.5 days (standard deviation, 1.9 d). One patient had additional posterior segmental instrumentation placed. Mean Cobb angles in the coronal plane were 28.5 degrees preoperatively and 18.3 degrees postoperatively (P < 0.05). We also present a historical perspective on retroperitoneal spine surgery, a regional anatomic description of the lumbosacral plexus and surrounding structures, and a description of the surgical technique as related to treatment of lumbar deformity.
AB - MINIMALLY INVASIVE AND interbody and instrumented fusion techniques are increasingly being used for the treatment of adult degenerative disc disease, stenosis, and deformity of the lumbar spine. Advocates of minimal access spinal approaches list certain advantages over open procedures, including decreased postoperative pain and narcotic requirements, shorter hospital stays, less blood loss, and smaller incisions. The minimally invasive anterolateral approach allows access to the lumbar spine through the retroperitoneal space. We report on the short-term clinical and radiographic outcomes in four patients with mid to high lumbar coronal deformities treated at our institution with the anterolateral transpsoas minimally invasive approach. The primary presentation of these patients was back and leg pain. All patients showed improvement in their preoperative symptoms and solid arthrodesis at 6 months. Independent nonbiased patient pain analysis was also performed. Mean follow-up was 10 months (standard deviation, 1.4 mo), and mean hospital stay was 3.5 days (standard deviation, 1.9 d). One patient had additional posterior segmental instrumentation placed. Mean Cobb angles in the coronal plane were 28.5 degrees preoperatively and 18.3 degrees postoperatively (P < 0.05). We also present a historical perspective on retroperitoneal spine surgery, a regional anatomic description of the lumbosacral plexus and surrounding structures, and a description of the surgical technique as related to treatment of lumbar deformity.
KW - Deformity correction
KW - Extreme-lateral transpsoas interbody approach
KW - Minimally invasive spine surgery
KW - Scoliosis
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U2 - 10.1227/01.NEU.0000325487.49020.91
DO - 10.1227/01.NEU.0000325487.49020.91
M3 - Article
C2 - 18812924
AN - SCOPUS:65849286871
VL - 63
SP - A191-A196
JO - Neurosurgery
JF - Neurosurgery
SN - 0148-396X
IS - 3 SUPPL.
ER -