• Giuseppe Barone, Laura Scaramuzzo, Antonino Zagra, Fabrizio Giudici, Andrea Perna, and Luca Proietti.
• Division of Orthopedic and Traumatology, Hospital S. Maria della Misericordia, University of the Study of Perugia, via Guido Monaco, 21, 06132, Perugia, Italy. giuseppe.barone@hotmail.com.
• Eur Spine J. 2017 Oct 1; 26 (Suppl 4): 457-463.

PurposeThe aim of the study is to assess and quantify the effectiveness of interbody lordotic cages applied by trans-psoas approach to improve radiographic parameters, showing the differences between completely mini-invasive and hybrid approach.MethodsWe collected data of 65 patients affected by degenerative lumbar deformity/diseases and underwent mini-invasive lateral interbody fusion followed by percutaneous (group A, completely mini-invasive) or open (group B, hybrid) posterior instrumentation. A subgroup underwent anterior column realignment (ACR). We assessed statistical differences in preoperative and postoperative (at least 6-month) coronal and sagittal parameters, and disc angle (DA) at each level of cage application.Results107 lordotic cages were implanted. Group B had the most significant mean changes, especially in coronal Cobb angle, sagittal vertical axis, lumbar lordosis (LL), pelvic incidence-LL mismatch and DA. Concerning DA, at each level of lordotic cage application, in group A changed from -2.9° preop to -6.5° postop (p = 0.01); in group B, DA changed from -2.6° to -9.5° (p = 0.002) and from +1° to -13.2° in patients underwent ACR.ConclusionsMinimally invasive lateral lumbar interbody fusion is an effective technique in improving sagittal parameters. When combined with posterior open approach and/or application of ACR procedure greater corrections are possible.

19 keywords...

hide…