Purpose

To evaluate the long-term clinical outcomes of degenerative lumbar scoliosis (DLS) with the administration of multisegment transforaminal lumbar interbody fusion (TLIF) combined with Ponte osteotomy long-level fixation fusion, as well as to identify the factors affecting health-related quality of life (HRQOL).

Methods

This was a retrospective single-centre study involving comprehensive clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) outcomes, and Scoliosis Research Society (SRS-22) questionnaire were recorded to assess HRQOL. A correlation analysis was performed to determine the association between HRQOL and radiographic parameters.

Results

A total of 41 consecutive patients (15 males and 26 females) met the inclusion criteria with a follow-up of 8.62 ± 1.20 years. Factors associated with HRQOL were significantly improved post-operation. Global sagittal parameters, including the sagittal vertebral axis (SVA) and T1 pelvic angle (TPA), and local parameters, including apical vertebral translation (AVT) and apical vertebral rotation (AVR), were significantly improved at the last follow-up. Significantly strong correlations between each clinical and radiographic parameter were demonstrated. Moreover, a multiple linear regression analysis demonstrated that the differences in AVT and AVR were significantly correlated with the difference in lumbar lordosis (LL), which was significantly correlated with the differences in SVA and TPA.

Conclusion

The surgical treatment of DLS with multisegment TLIF accompanied by Ponte osteotomy and long-level fixations improved the quality of life of patients with a long-term effect. AVR correction is an important factor for LL restoration that significantly correlates with improvements in the sagittal balance parameters SVA and TPA, which are key factors for guaranteeing good HRQOL.

中文翻译：

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多节段经椎间孔腰椎椎间融合术 (TLIF) 联合 Ponte 截骨术治疗退变性腰椎侧凸 (DLS) 手术：至少五年的随访

目的

评估多节段经椎间孔腰椎椎体间融合术（TLIF）联合 Ponte 截骨长节段固定融合治疗退变性腰椎侧弯（DLS）的长期临床结果，并确定影响患者健康相关质量的因素生活（HRQOL）。

方法

这是一项涉及综合临床数据的回顾性单中心研究。记录 Oswestry 残疾指数 (ODI)、视觉模拟量表 (VAS) 结果和脊柱侧弯研究协会 (SRS-22) 问卷以评估 HRQOL。进行相关性分析以确定 HRQOL 和影像学参数之间的关联。

结果

共有 41 名连续患者（15 名男性和 26 名女性）符合纳入标准，随访时间为 8.62 ± 1.20 年。与 HRQOL 相关的因素在术后显着改善。包括矢状椎轴 (SVA) 和 T1 骨盆角 (TPA) 在内的全局矢状参数，以及包括顶椎平移 (AVT) 和顶椎旋转 (AVR) 在内的局部参数，在末次随访时均有显着改善。证明了每个临床和放射学参数之间的显着强相关性。此外，多元线性回归分析表明，AVT 和 AVR 的差异与腰椎前凸 (LL) 的差异显着相关，而腰椎前凸与 SVA 和 TPA 的差异显着相关。

结论

多节段 TLIF 伴随 Ponte 截骨术和长节段固定的 DLS 手术治疗改善了患者的生活质量，具有长期效果。AVR 校正是 LL 恢复的一个重要因素，它与矢状平衡参数 SVA 和 TPA 的改善显着相关，而矢状平衡参数 SVA 和 TPA 是保证良好 HRQOL 的关键因素。