238
· DOS Abstracts
Stand-alone XLIF; 22 Consecutive patients with
degenerative scoliosis and foraminal stenosis a 2
year follow-up
Emil Hansen
Sector for Spine surgery and Research, Middelfart Hospital
Background:
The extreme lateral approach to the intervertebral spaces in the
lumbar and thoracic spine is a procedure developed to allow a larger footprint
cage to be inserted when performing spondylodesis. In the litterature not many
studies have been made to investigate the role of the cage as a stand-alone
option for degenerative scoliosis. While the patients often are fragile and with
poor bone quality, a single surgical option, preserving the posterior structures,
could be beneficial.
Purpose / Aim of Study:
The purpose of the study is to evaluate the compli-
cation rate and clinical/radiological results in DS patients undergoing spondylod-
esis with a XLIF stand-alone procedure
Materials and Methods:
22 consecutive patients with DS, underwent surgery
with the XLIF stand-alone procedure, follow-up 24 months. Validated clinical
outcome scores were collected preoperatively, at 1 and 2 years. Complications
were recorded.
Findings / Results:
22 patients with a mean age of 65 (48-81) underwent
surgery on 49 levels (1-4) between L1-L5. Visual Analog scores for leg pain
improved from 59,4-34,9 (P<0,05) and back pain from 59,1-36,8 (P<0,05).
EQ5D scores improved from 0,29-0,62 (P<0,05). 7 patients (31,8 %) under-
went revision surgery. Osseous fusion was obtained in 53% of the treated levels
at 1 year. Anterior thigh pain was recorded in 12 patients postoperatively but
only 2 had consistent sypmtoms at 1 year follow-up.
Conclusions:
The XLIF stand-alone procedure is a relatively safe procedure
compared with other surgical alternatives as ALIF and PLIF. Our results show
a significant improvement in clinical outcome scores during 2 year follow-up.
Stand alone XLIF should only be advised for single-level and only mild deformity.
In most cases we recommend posterior instrumentation.
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