BACKGROUND Spinal surgery performed entirely with minimally invasive surgery is referred to as circumferential MIS (cMIS). However, cMIS still has a limited sagittal correction capability for adult spinal deformity (ASD) with a marked sagittal deformity. We investigated the effectiveness of cMIS using oblique lateral interbody fusion (OLIF) and percutaneous posterior spine fixation in correcting marked sagittal deformity. METHODS This study retrospectively evaluated 23 patients with ASD with marked sagittal deformity who underwent cMIS using OLIF without osteotomy and were followed-up for at least 24 months (whole group). The whole group was divided into the following two groups according to the type of interbody fusion at L5-S1: the OLIF51 group (n = 13) underwent OLIF at L1-L5 and L5-S1 and the TLIF51 group (n = 10) underwent OLIF at L1-L5 and transforaminal lumbar interbody fusion (TLIF) at L5-S1. RESULTS Sagittal vertebral axis (SVA; 125.7 vs. 29.5 mm, p < 0.001), lumbar lordosis (LL; 18.2° vs. 51.7°, p < 0.001), and pelvic incidence-LL mismatch (PI-LL, 35.5° vs. 5.3°) significantly improved postoperatively in the whole group. The OLIF51 group showed significantly higher postoperative LL than the TLIF51 group (55.5° vs. 46.9°, p < 0.001). OLIF yielded a significantly greater disc angle at L5-S1 than did TLIF (18.4° vs. 6.9°, p < 0.001). Proximal junctional kyphosis occurred significantly earlier in the OLIF51 group than in the TLIF51 group (8.6 vs. 26.3 months, p < 0.001). CONCLUSION Successful sagittal correction in ASD patients with marked sagittal deformity was achieved with cMIS using OLIF. OLIF at L5-S1 showed a synergistic effect in sagittal deformity correction by cMIS.

中文翻译：

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在成人脊柱畸形中采用斜向外侧椎体融合术进行周向微创手术，以矫正明显的矢状畸形。

背景技术完全用微创外科手术执行的脊柱外科手术被称为周向MIS（cMIS）。但是，cMIS对成人脊柱畸形（ASD）的矢状面矫正能力仍然有限，并具有明显的矢状畸形。我们研究了使用斜外侧椎体融合术（OLIF）和经皮后路脊柱固定术治疗cMIS的有效性，以纠正明显的矢状畸形。方法这项研究回顾性评估了23例具有明显矢状畸形的ASD患者，他们使用无截骨的OLIF进行cMIS，并随访了至少24个月（整个组）。根据L5-S1处的椎间融合的类型，将整个组分为以下两组：OLIF51组（n = 13）在L1-L5和L5-S1接受OLIF，而TLIF51组（n = 10）在L1-L5接受OLIF，经椎间孔腰椎椎间融合术（TLIF）在L5-S1接受。结果矢状椎轴（SVA; 125.7 vs. 29.5 mm，p <0.001），腰椎前凸（LL; 18.2°vs. 51.7°，p <0.001），以及骨盆发病率-LL不匹配（PI-LL，35.5°vs.整个组的术后5.3°）明显改善。OLIF51组术后LL明显高于TLIF51组（55.5°vs. 46.9°，p <0.001）。与TLIF相比，OLIF在L5-S1处产生的椎间盘角度明显更大（18.4°vs. 6.9°，p <0.001）。与TLIF51组相比，OLIF51组的近端结节后凸发生得更早（8.6 vs. 26.3个月，p <0.001）。结论使用OLIF的cMIS可成功完成ASD矢状面畸形患者的矢状面矫正。L5-S1处的OLIF在cMIS校正矢状畸形中显示出协同作用。