E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Optimising Spinopelvic Harmony: The Role of Strategic Transforaminal Lumbar Interbody Fusion (TLIF) and Long Fusion in Adult Degenerative Scoliosis
Samarth Mittal✉ ,
Aakash Jain ,
Siddharth Sethy ,
Rahul Baishya ,
Aman Verma ,
Bhaskar Sarkar ,
Kaustubh Ahuja ,
Pankaj Kandwal ,
Rahul Karn ,
Syed Ifthekar
Aakash Jain ,
Siddharth Sethy ,
Rahul Baishya ,
Aman Verma ,
Bhaskar Sarkar ,
Kaustubh Ahuja ,
Pankaj Kandwal ,
Rahul Karn ,
Syed Ifthekar
Orthopedics, AIIMS Rishikesh
DOI: 10.5137/1019-5149.JTN.49884-25.3
Article in Press
Corresponding Author:
Samarth Mittal (shankymtl11@gmail.com)
Abstract
Aim
To evaluate the clinical and radiological outcomes after deformity correction with long-segment (>3 levels) posterior fixation and strategic TLIF in Adult Degenerative Lumbar Scoliosis and to find the correlation between clinical and radiological parameters.
Material and Methods
Materials and Methods: This was a prospective single-centre study involving comprehensive clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) outcomes, and Scoliosis Research Society (SRS-22) questionnaire were recorded to assess Health Related Quality Of Life (HRQOL). A correlation analysis determined the association between HRQOL and radiographic parameters.
Results
Results: A total of 39 consecutive patients (15 males and 24 females) met the inclusion criteria with a mean follow-up of 24.5 ± 7.2 months, and the mean age was 60.13 ± 8.07 years. Factors associated with HRQOL were significantly improved post-operation. VAS back scores improved from 7.54 ± 1.33 to 2.42 ± 0.17 (p < 0.0001), and VAS leg scores improved from 6.72 ± 1.32 to 1.37 ± 0.28. ODI scores improved from 70.27 ± 18.04% to 27 ± 7.07% (p < 0.0001). SRS scores significantly improved in all domains except self-image. Coronal Cobb angles were corrected from 21.23 ± 8.13 to 3.4 ± 1.83 (88% correction, p = 0.014). Lumbar lordosis (LL) improved from 22.47 ± 12.32 to 39.73 ± 4.06 (p = 0.023). The Sagittal Vertical Axis (SVA) improved from 48.7 ± 22.7 mm to 37.17 ± 25.13 mm (p = 0.027). Significant changes were observed in Pelvic Tilt (PT) , Sacral Slope (SS) and Pelvic Incidence Lumbar lordosis(PI-LL). Significant correlations were found between changes in VAS and LL, PT, SS, SVA, and PI-LL. No coronal parameter showed a correlation with clinical outcomes.
Conclusion
Conclusion: Long-segment posterior fixation and strategic TLIF provide good clinical and radiological outcomes. Restoration of sagittal and spinopelvic parameters is more crucial than coronal deformity correction for good clinical outcomes.
To evaluate the clinical and radiological outcomes after deformity correction with long-segment (>3 levels) posterior fixation and strategic TLIF in Adult Degenerative Lumbar Scoliosis and to find the correlation between clinical and radiological parameters.
Material and Methods
Materials and Methods: This was a prospective single-centre study involving comprehensive clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) outcomes, and Scoliosis Research Society (SRS-22) questionnaire were recorded to assess Health Related Quality Of Life (HRQOL). A correlation analysis determined the association between HRQOL and radiographic parameters.
Results
Results: A total of 39 consecutive patients (15 males and 24 females) met the inclusion criteria with a mean follow-up of 24.5 ± 7.2 months, and the mean age was 60.13 ± 8.07 years. Factors associated with HRQOL were significantly improved post-operation. VAS back scores improved from 7.54 ± 1.33 to 2.42 ± 0.17 (p < 0.0001), and VAS leg scores improved from 6.72 ± 1.32 to 1.37 ± 0.28. ODI scores improved from 70.27 ± 18.04% to 27 ± 7.07% (p < 0.0001). SRS scores significantly improved in all domains except self-image. Coronal Cobb angles were corrected from 21.23 ± 8.13 to 3.4 ± 1.83 (88% correction, p = 0.014). Lumbar lordosis (LL) improved from 22.47 ± 12.32 to 39.73 ± 4.06 (p = 0.023). The Sagittal Vertical Axis (SVA) improved from 48.7 ± 22.7 mm to 37.17 ± 25.13 mm (p = 0.027). Significant changes were observed in Pelvic Tilt (PT) , Sacral Slope (SS) and Pelvic Incidence Lumbar lordosis(PI-LL). Significant correlations were found between changes in VAS and LL, PT, SS, SVA, and PI-LL. No coronal parameter showed a correlation with clinical outcomes.
Conclusion
Conclusion: Long-segment posterior fixation and strategic TLIF provide good clinical and radiological outcomes. Restoration of sagittal and spinopelvic parameters is more crucial than coronal deformity correction for good clinical outcomes.
Keywords
Scoliosis/surgery
Spinal Fusion/methods
Lumbar Vertebrae/surgery
Adult
Degeneration