Two-year radiographic and clinical outcomes of a minimally invasive, lateral, transpsoas approach for anterior lumbar interbody fusion in the treatment of adult degenerative scoliosis.

PURPOSE: The purpose of this study was to examine radiographic and clinical outcomes in the treatment of adult degenerative scoliosis using a minimally invasive (MI) lateral approach for anterior lumbar interbody fusion (IBF).
METHODS: A prospective study of 24 consecutive degenerative scoliosis patients treated with MI, 90° lateral, transpsoas approach for anterior IBF was conducted. Twenty-one patients (88 %) were available for at least 12 months follow-up (mean 24 months).
RESULTS: Mean operating time, estimated blood loss, and length of stay was 218 min, 68 mL, and 2.2 days, respectively. Complications occurred in one (5 %) case, a postoperative foot drop. At the last follow-up, disability improved by 50 % from 48.4 to 24.4. Back pain improved by 59 % from 7.0 to 2.9. Leg pain improved by 41 % from 5.6 to 3.3. In patients with a baseline score greater than 2.0, leg pain decreased by 42 % from 6.6 to 3.8. SF-36 physical component score improved by 41 % from 28.0 to 39.6, while mental component score increased by 18 % from 42.2 to 49.8. All changes were statistically significant, p < 0.05. Cobb angle was corrected from 27.7° to 16.6° and lumbar lordosis increased 39 % from -31.8° to -44.0°. Disc height increased from 5.7 to 11.6 mm, segmental lordosis increased by 48 % from 11.6° to 17.2°, and foraminal height increased from 16.4 to 21.7 mm. At the last follow-up, 100 % of patients were satisfied with their outcome, and 86 % would undergo the same procedure again. No revisions occurred.
CONCLUSIONS: MI lateral IBF in the treatment of degenerative scoliosis results in lower complication rates and clinical and radiographic outcomes equivalent to reports in the literature of conventional approaches.