Adult Deformity Correction Through Minimally Invasive Lateral Approach Techniques

作者：Mundis Gregory M; Akbarnia Behrooz A^*; Phillips Frank M

来源：Spine, 2010, 35(26): S312-S321.

DOI：10.1097/BRS.0b013e318202495f

• minimally invasive lateral approach
• adult scoliosis
• lumbosacral plexus
• degenerative scoliosis

Study Design. Review of the available literature, authors' opinion.
Objective. To review the literature on minimally invasive lateral approach for interbody fusion in treatment of adult deformity. To describe the key points of pertinent surgical anatomy and outline the results of our experience with this technique.
Summary of Background Data. Minimally invasive surgery in the management of adult spinal deformity has been introduced to minimize the postoperative morbidity and facilitate earlier recovery in a group of medically fragile patients.
Methods. Literature review.
Results. Both patient-centered outcome measures (including Oswestry Disability Index, Visual Analogue Scale, and SRS-22) and objective results (correction of coronal and sagittal deformity) are significantly improved in most studies. Reported complication rates differ from one study to another but major complications are low. Infrequent neurologic complications occurred; however, most surgical sequelae were transient and had resolved at later follow-up. The lower blood loss and shorter hospital stay are further benefits of the minimally invasive techniques when compared with results reported for open anterior surgeries for patients with adult deformity.
Conclusion. The current expertise of minimally invasive techniques in the management of adult spinal deformity is exponentially evolving, yet even the preliminary outcomes seem quite promising. Acknowledging the details of meticulous surgical technique and local anatomy (e.g., lumbosacral plexus and blood vessels) is the essential key to improving outcomes and reducing the risk of complications.

• 出版日期2010-12-15