Comparison of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion as Corrective Surgery for Patients with Adult Spinal Deformity-A Propensity Score Matching Analysis

October 26, 2021

. 2021 Oct 15;10(20):4737.

doi: 10.3390/jcm10204737.

Yu Matsukura¹, Toshitaka Yoshii¹, Shingo Morishita¹, Kenichiro Sakai², Takashi Hirai¹, Masato Yuasa¹, Hiroyuki Inose¹, Atsuyuki Kawabata¹, Kurando Utagawa¹, Jun Hashimoto¹, Masaki Tomori², Ichiro Torigoe², Tsuyoshi Yamada³, Kazuo Kusano³, Kazuyuki Otani³, Satoshi Sumiya⁴, Fujiki Numano⁴, Kazuyuki Fukushima⁵, Shoji Tomizawa⁶, Satoru Egawa¹, Yoshiyasu Arai², Shigeo Shindo³, Atsushi Okawa¹

Affiliations

¹ Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
² Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi 332-8558, Japan.
³ Department of Orthopaedic Surgery, Kudanzawa Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo 102-0074, Japan.
⁴ Department of Orthopaedic Surgery, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama 231-8682, Japan.
⁵ Department of Orthopaedic Surgery, Saku General Hospital, 3400-28 Nakagomi, Saku 385-0051, Japan.
⁶ Department of Orthopaedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Toudaijima, Urayasu 279-0001, Japan.

Free PMC article

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Yu Matsukura et al.

J Clin Med.

2021.

Free PMC article

. 2021 Oct 15;10(20):4737.

doi: 10.3390/jcm10204737.

Authors

Affiliations

¹ Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
² Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi 332-8558, Japan.
³ Department of Orthopaedic Surgery, Kudanzawa Hospital, 1-6-12 Kudanminami, Chiyoda-ku, Tokyo 102-0074, Japan.
⁴ Department of Orthopaedic Surgery, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Naka-ku, Yokohama 231-8682, Japan.
⁵ Department of Orthopaedic Surgery, Saku General Hospital, 3400-28 Nakagomi, Saku 385-0051, Japan.
⁶ Department of Orthopaedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Toudaijima, Urayasu 279-0001, Japan.

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Abstract

Lateral lumbar interbody fusion (LLIF) is increasingly performed as corrective surgery for patients with adult spinal deformity (ASD). This paper compares the surgical results of LLIF and conventional posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) in ASD using a propensity score matching analysis. We retrospectively reviewed patients with ASD who received LLIF and PLIF/TLIF, and investigated patients’ backgrounds, radiographic parameters, and complications. The propensity scores were calculated from patients’ characteristics, including radiographic parameters and preoperative comorbidities, and one-to-one matching was performed. Propensity score matching produced 21 matched pairs of patients who underwent LLIF and PLIF/TLIF. All radiographic parameters significantly improved in both groups at the final follow-up compared with those of the preoperative period. The comparison between both groups demonstrated no significant difference in terms of postoperative pelvic tilt, lumbar lordosis (LL), or pelvic incidence-LL at the final follow-up. However, the sagittal vertical axis tended to be smaller in the LLIF at the final follow-up. Overall, perioperative and late complications were comparable in both procedures. However, LLIF procedures demonstrated significantly less intraoperative blood loss and a smaller incidence of postoperative epidural hematoma compared with PLIF/TLIF procedures in patients with ASD.

Keywords:

adult spinal deformity (ASD); degenerative adult deformity; lateral lumbar interbody fusion; perioperative complications; posterior lumbar interbody fusion; sagittal correction; surgical invasiveness.

Conflict of interest statement

The authors declare no conflict of interest.

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