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首页> 外文期刊>Neurosurgical focus >Preliminary results of anterior lumbar interbody fusion, anterior column realignment for the treatment of sagittal malalignment
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Preliminary results of anterior lumbar interbody fusion, anterior column realignment for the treatment of sagittal malalignment

机译：腰椎前路椎体间融合术，前柱复位治疗矢状位错位的初步结果

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OBJECTIVE Sagittal malalignment decreases patients’ quality of life and may require surgical correction to achieve realignment goals. High-risk posterior-based osteotomy techniques are the current standard treatment for addressing sagittal malalignment. More recently, anterior lumbar interbody fusion, anterior column realignment (ALIF ACR) has been introduced as an alternative for correction of sagittal deformity. The objective of this paper was to report clinical and radiographic results for patients treated using the ALIF-ACR technique. METHODS A retrospective study of 39 patients treated with ALIF ACR was performed. Patient demographics, operative details, radiographic parameters, neurological assessments, outcome measures, and preoperative, postoperative, and mean 1-year follow-up complications were studied. RESULTS The patient population comprised 39 patients (27 females and 12 males) with a mean follow-up of 13.3 ± 4.7 months, mean age of 66.1 ± 11.6 years, and mean body mass index of 27.3 ± 6.2 kg/m2. The mean number of ALIF levels treated was 1.5 ± 0.5. Thirty-three (84.6%) of 39 patients underwent posterior spinal fixation and 33 (84.6%) of 39 underwent posterior column osteotomy, of which 20 (60.6%) of 33 procedures were performed at the level of the ALIF ACR. Pelvic tilt, sacral slope, and pelvic incidence were not statistically significantly different between the preoperative and postoperative periods and between the preoperative and 1-year follow-up periods (except for PT between the preoperative and 1-year follow-up, p = 0.018). Sagittal vertical axis, T-1 spinopelvic inclination, lumbar lordosis, pelvic incidence–lumbar lordosis mismatch, intradiscal angle, and motion segment angle all improved from the preoperative to postoperative period and the preoperative to 1-year follow-up (p CONCLUSIONS This study showed satisfactory radiographic and clinical outcomes at the 1-year follow-up. Proximal junctional kyphosis was the most common complication followed by fracture, complications that are commonly associated with sagittal realignment surgery and may not be mitigated by the anterior approach.
机译：目的矢状位错位会降低患者的生活质量，可能需要进行手术矫正才能达到重新对准的目的。基于高风险的后路截骨术是解决矢状位错位的当前标准治疗方法。最近，已引入前腰椎椎间融合术，前柱再对准（ALIF ACR）作为矫正矢状畸形的替代方法。本文的目的是报告使用ALIF-ACR技术治疗的患者的临床和影像学结果。方法对39例接受ALIF ACR治疗的患者进行回顾性研究。研究了患者的人口统计学，手术细节，影像学参数，神经学评估，结果指标以及术前，术后和平均1年随访并发症。结果该患者人群包括39名患者（27名女性和12名男性），平均随访时间为13.3±4.7个月，平均年龄为66.1±11.6岁，平均体重指数为27.3±6.2 kg / m 2 。治疗的ALIF水平的平均数为1.5±0.5。 39例患者中有33例（84.6％）接受了脊柱后路固定，39例患者中有33例（84.6％）接受了后柱截骨术，其中33例中有20例（60.6％）采用了ALIF ACR水平。术前和术后以及术前和1年随访之间的骨盆倾斜度，骨斜率和骨盆发生率无统计学差异（术前和1年随访之间的PT除外，p = 0.018） ）。从术前至术后及术前至1年随访期间，矢状纵轴，T-1脊柱盆腔倾斜度，腰椎前凸，盆腔发病率-腰椎前凸失调，椎间盘内角和运动节段角均得到改善（p结论）在1年的随访中显示出令人满意的影像学和临床结果，近端结节型后凸畸形是最常见的并发症，其次是骨折，并发症，这些并发症通常与矢状位整形手术有关，并且前路手术可能无法缓解。

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