A Modified Anterior Column Realignment With Partial Anterior Longitudinal Ligament Release in Oblique Lateral Interbody Fusion
- 주제(키워드) anterior column lengthening , anterior longitudinal ligament , oblique lateral interbody fusion , posterior column osteotomy , adult deformity surgery
- 주제(DDC) 610
- 발행기관 아주대학교 일반대학원
- 지도교수 정남수
- 발행년도 2024
- 학위수여년월 2024. 8
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000034070
- 본문언어 한국어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Anterior column realignment (ACR) remains a powerful sagittal correction technique in minimally invasive adult spinal deformity surgery and is often combined with posterior column osteotomy (PCO) to achieve more lordosis. OLIF is ideal for ACR because the anterior-to-psoas corridor typically involves the anterolateral half of the disk. This study included 112 operated disk levels of 101 consecutive patients who underwent OLIF between L2–L3 and L4– L5 using a 12° lateral cage. The mACR was performed at 73 (65.2%) levels with 30% to 50% sectioning of the ALL. Each operated level was grouped according to the mACR and additional PCO as. (1) no mACR, OLIF only (n = 39); (2) mACR with no PCO (n = 18); (3) mACR with grade 1 PCO (n = 27); (4) mACR with grade 2 PCO (n = 22); or (5) mACR with grade 3 PCO (n = 6). At the last follow-up, the mean disk lordotic angles were 10.9 ± 2.9°, 12.6 ± 3.0°, 13.3 ± 3.9°, 16.7 ± 3.2°, and 16.8 ± 2.4° in the no mACR, mACR with no PCO, mACR with grade 1 PCO, mACR with grade 2 PCO, and mACR with grade 3 PCO groups, respectively (P < 0.001). The mean increases in disk lordotic angle were 5.8 ± 4.1°, 12.1 ± 6.1°, 13.5 ± 8.7°, 15.8 ± 6.7°, and 17.9 ± 6.2° in each group, respectively (P < 0.001). ACR can be performed with partial ALL release under direct vision in OLIF without deep dissection into the ventral disk space. The mACR in OLIF is a simple, safe, and effective technique for anterior column lengthening.
more목차
I . Introduction 1
II . Methods 3
A. Study Participants 3
B. Surgical techinque 4
a. OLIF procedure 4
b. Modified Anterior Column Realignment 5
c. Posterior Procedure 6
C. Radiological Evaluation 6
D. Statistical Analysis 8
III . Results 10
A. Patients' Demographics 10
B. Radiological Outcomes 12
a . Disk Lordotic Angle 12
b. Anterior and Posterior Disk Heights 13
c . Sagittal Parameters 14
d. Fusion Rate and Cage Subsidence 15
C. Perioperative Complications 15
IV. Discussion 16
V. Conclusion 22
References 23
