Bartlett Alyssa M, Dibble Christopher F, Sykes David A W, Drossopoulos Peter N, Wang Timothy Y, Crutcher Clifford L, Than Khoi D, Bhomwick Deb A, Shaffrey Christopher I, Abd-El-Barr Muhammad M
Department of Neurosurgery, Duke University, Durham, NC 27710, USA.
Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
J Clin Med. 2024 Apr 15;13(8):2279. doi: 10.3390/jcm13082279.
Lateral spine surgery offers effective minimally invasive deformity correction, but traditional approaches often involve separate anterior, lateral, and posterior procedures. The prone lateral technique streamlines this process by allowing single-position access for lateral and posterior surgery, potentially benefiting from the lordosing effect of prone positioning. While previous studies have compared prone lateral to direct lateral for adult degenerative diseases, this retrospective review focuses on the outcomes of adult deformity patients undergoing prone lateral interbody fusion. Ten adult patients underwent single-position prone lateral surgery for spine deformity correction, with a mean follow-up of 18 months. Results showed significant improvements: sagittal vertical axis decreased by 2.4 cm, lumbar lordosis increased by 9.1°, pelvic tilt improved by 3.3°, segmental lordosis across the fusion construct increased by 12.2°, and coronal Cobb angle improved by 6.3°. These benefits remained consistent over the follow-up period. Correlational analysis showed a positive association between improvements in PROs and SVA and SL. When compared to hybrid approaches, prone lateral yielded greater improvements in SVA. Prone lateral surgery demonstrated favorable outcomes with reasonable perioperative risks. However, further research comparing this technique with standard minimally invasive lateral approaches, hybrid, and open approaches is warranted for a comprehensive evaluation.
脊柱外侧手术可提供有效的微创畸形矫正,但传统方法通常涉及单独的前路、外侧和后路手术。俯卧位外侧技术通过允许在单一位置进行外侧和后路手术简化了这一过程,可能受益于俯卧位的前凸效应。虽然先前的研究已将成人退行性疾病的俯卧位外侧手术与直接外侧手术进行了比较,但这项回顾性研究聚焦于接受俯卧位外侧椎间融合术的成人脊柱畸形患者的治疗结果。十名成年患者接受了单位置俯卧位外侧手术以矫正脊柱畸形,平均随访18个月。结果显示有显著改善:矢状垂直轴减少2.4厘米,腰椎前凸增加9.1°,骨盆倾斜改善3.3°,融合节段的节段性前凸增加12.2°,冠状面Cobb角改善6.3°。这些益处随访期间保持一致。相关性分析显示患者报告结局(PROs)、矢状垂直轴(SVA)和节段性腰椎前凸(SL)的改善之间呈正相关。与混合手术方法相比,俯卧位外侧手术在矢状垂直轴方面改善更大。俯卧位外侧手术显示出良好的治疗效果以及合理的围手术期风险。然而,有必要进一步研究将该技术与标准微创外侧手术方法、混合手术方法和开放手术方法进行比较,以进行全面评估。