Yeh Chun, Hsiao Pang-Hsuan, Chen Michael Jian-Wen, Lo Yuan-Shun, Tseng Chun, Lin Chia-Yu, Li Ling-Yi, Lai Chien-Ying, Chang Chien-Chun, Chen Hsien-Te
Department of Education, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan.
Department of Orthopaedic Surgery, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan.
BMC Musculoskelet Disord. 2025 Apr 2;26(1):318. doi: 10.1186/s12891-025-08550-x.
The aging population is experiencing a rising incidence of musculoskeletal problems and degenerative spinal deformities. Adult spinal deformity (ASD) presents challenges, with associated risks in open surgery. Minimally invasive surgery (MIS) is becoming increasingly popular due to its positive outcomes and potential benefits. This study aims to explore the clinical outcome and complications of posterior approach MIS in patients with ASD.
We conducted a retrospective analysis of patients with adult spinal deformity who underwent posterior minimally invasive surgery. 46 patients meeting the criteria were identified between June 2017 and September 2023. Comprehensive data were collected, including demographic details, surgical information, full-length radiographic measurements, and visual analog scale (VAS) pain scores. These data were obtained preoperatively, postoperatively, and at the final follow-up.
A total of 46 patients were included in the study, with a mean age of 68.58 years and a minimum follow-up period of 6 months. The mean operative time was 327 min, and the mean blood loss was 307 ml. Preoperative radiographic measurements were as follows: Coronal Cobb angle, 18.60 ± 11.35°; lumbar lordosis (LL), 22.79 ± 21.87°; pelvic incidence (PI), 53.05 ± 14.13°; PI-LL mismatch, 30.26 ± 23.48°; pelvic tilt (PT), 32.53 ± 10.38°; T1 pelvic angle (TPA), 31.91 ± 12.39°; and sagittal vertical axis (SVA), 77.77 ± 60.47 mm. At the final follow-up, coronal Cobb angle was 10.08 ± 6.47° (P <0.0001), LL was 26.16 ± 16.92° (P = 0.4293), PI was 54.17 ± 12.13° (P = 0.6965), PI-LL mismatch was 28.00 ± 17.03° (P = 0.6144), PT was 27.74 ± 10.24° (P = 0.0345), TPA was 25.10 ± 10.95 (P = 0.0090) and SVA was 47.91 ± 46.94 mm (P = 0.0129). Functional outcomes improved as well, with the mean Oswestry Disability Index (ODI) decreasing from 34.9 to 23.6 and the Visual Analog Scale (VAS) score for back pain reducing from 8.4 to 3.4. Surgical complications occurred in 39.1% of cases, with a low reoperation rate of 4.3%.
Single-staged posterior MIS effectively corrects global alignment in adult spinal deformities, satisfying patient demand and yielding positive clinical outcome with low re-operation rate.
老龄化人口中肌肉骨骼问题和退行性脊柱畸形的发病率不断上升。成人脊柱畸形（ASD）带来了挑战，开放手术存在相关风险。由于其良好的效果和潜在益处，微创手术（MIS）越来越受欢迎。本研究旨在探讨后路MIS治疗ASD患者的临床疗效和并发症。
我们对接受后路微创手术的成人脊柱畸形患者进行了回顾性分析。在2017年6月至2023年9月期间确定了46例符合标准的患者。收集了全面的数据，包括人口统计学细节、手术信息、全长影像学测量以及视觉模拟量表（VAS）疼痛评分。这些数据在术前、术后和最终随访时获取。
本研究共纳入46例患者，平均年龄68.58岁，最短随访期6个月。平均手术时间为327分钟，平均失血量为307毫升。术前影像学测量结果如下：冠状面Cobb角，18.60±11.35°；腰椎前凸（LL），22.79±21.87°；骨盆入射角（PI），53.05±14.13°；PI-LL失配，30.26±23.48°；骨盆倾斜（PT），32.53±10.38°；T1骨盆角（TPA），31.91±12.39°；矢状垂直轴（SVA），77.77±60.47毫米。在最终随访时，冠状面Cobb角为10.08±6.47°（P<0.0001），LL为26.16±16.92°（P = 0.4293），PI为54.17±12.13°（P = 0.6965），PI-LL失配为28.00±17.03°（P = 0.6144），PT为27.74±10.24°（P = 0.0345），TPA为25.10±10.95（P = 0.0090），SVA为47.91±46.94毫米（P = 0.0129）。功能结局也有所改善，平均Oswestry功能障碍指数（ODI）从34.9降至23.6，背痛视觉模拟量表（VAS）评分从8.4降至3.4。39.1%的病例发生手术并发症，再次手术率低至4.3%。
单阶段后路MIS能有效矫正成人脊柱畸形的整体对线，满足患者需求，临床疗效良好，再次手术率低。
