TY - JOUR

T1 - Llif en la correcciÓn de la escoliosis degenerativa en pacientes de la tercera edad

AU - Klimov, Vladimir Sergeevich

AU - Vasilenko, Ivan Igorevich

AU - Rzaev, Jamil Afetovich

AU - Evsyukov, Alexey Vladimirovich

AU - Khalepa, Roman Vladimirovich

AU - Amelina, Evgeniya Valeryevna

AU - Ryabykh, Sergey Olegovych

AU - Sinha, Priyank

AU - Ivanov, Marcel

N1 - Publisher Copyright: © 2020 Oficial da Sociedade Brasileira de Coluna. All rights reserved. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020

Y1 - 2020

N2 - Objective: The incidence of adult degenerative scoliosis (ADS) among individuals over 50 years old can be as high as 68%. Surgical interventions aimed at correcting the spinal deformity in elderly patients are accompanied by a high risk of complications. The use of lateral lumbar interbody fusion (LLIF) is associated with lower rates of complications when compared with open anterior or posterior fusions. Methods: Ninety-three patients with ADS (23 men, 70 women) were operated at the Federal Neurosurgical Center. The average age was 63 (52 to 73 years). Results: Back pain, measured according to the Visual Analogue Scale (VAS), decreased from 5.9/6 (4;8) (format – mean/ median (1;3 quartile)) to 2.6/3 (1;3) points (p <0.0001). Leg pain according to the VAS decreased from 4.6/4 (3;7) to 1.4/1 (0;2) points (p < 0.0001). Functional adaptation according to the Oswestry Disability Index (ODI) improved from 47.8±17.4 to 38.5±14.5 (p < 0.0273). Pelvic tilt (PT) before the surgery was 23.9±12.2° whereas at 12 months follow-up it was 16.8±5.9° (p < 0.0001). PI-LL mismatch pre surgery was 12.1/13 (9;16)° whereas 12 months later it was 7.9/8 (6;10)° (p = 0.0002). Conclusions: Restoration of local sagittal balance in ADS patients by short-segment fixation using LLIF technology leads to a statistically significant improvement in quality of life and increased functional adaptation. A lower incidence of early and late postoperative complications, less intraoperative blood loss and shorter hospital stay makes LLIF, in combination with minimally invasive transpedicular fixation, the method of choice to correct ADS in elderly patients. Level of evidence IV; Case series.

AB - Objective: The incidence of adult degenerative scoliosis (ADS) among individuals over 50 years old can be as high as 68%. Surgical interventions aimed at correcting the spinal deformity in elderly patients are accompanied by a high risk of complications. The use of lateral lumbar interbody fusion (LLIF) is associated with lower rates of complications when compared with open anterior or posterior fusions. Methods: Ninety-three patients with ADS (23 men, 70 women) were operated at the Federal Neurosurgical Center. The average age was 63 (52 to 73 years). Results: Back pain, measured according to the Visual Analogue Scale (VAS), decreased from 5.9/6 (4;8) (format – mean/ median (1;3 quartile)) to 2.6/3 (1;3) points (p <0.0001). Leg pain according to the VAS decreased from 4.6/4 (3;7) to 1.4/1 (0;2) points (p < 0.0001). Functional adaptation according to the Oswestry Disability Index (ODI) improved from 47.8±17.4 to 38.5±14.5 (p < 0.0273). Pelvic tilt (PT) before the surgery was 23.9±12.2° whereas at 12 months follow-up it was 16.8±5.9° (p < 0.0001). PI-LL mismatch pre surgery was 12.1/13 (9;16)° whereas 12 months later it was 7.9/8 (6;10)° (p = 0.0002). Conclusions: Restoration of local sagittal balance in ADS patients by short-segment fixation using LLIF technology leads to a statistically significant improvement in quality of life and increased functional adaptation. A lower incidence of early and late postoperative complications, less intraoperative blood loss and shorter hospital stay makes LLIF, in combination with minimally invasive transpedicular fixation, the method of choice to correct ADS in elderly patients. Level of evidence IV; Case series.

KW - Adult

KW - Deformity

KW - Quality of Life

KW - Scoliosis

KW - Spine

UR - http://www.scopus.com/inward/record.url?scp=85095956140&partnerID=8YFLogxK

U2 - 10.1590/S1808-185120201904230798

DO - 10.1590/S1808-185120201904230798

M3 - статья

AN - SCOPUS:85095956140

VL - 19

SP - 243

EP - 248

JO - Coluna/ Columna

JF - Coluna/ Columna

SN - 1808-1851

IS - 4

ER -