Background Lumbar interbody fusion(LIF) is the leading way to treat Lumbar Degenerative Diseases(LDD). At present, there is a lack of research on the influencing factors of hidden blood loss in minimally invasive hybrid lumbar interbody fusion. This study comprehensively explores the definite factors affecting the hidden blood loss in minimally invasive hybrid lumbar interbody fusion. Materials and methods One hundred patients with Lumbar degenerative diseases who underwent minimally invasive hybrid lumbar interbody fusion in our center were included. Demographics, laboratory data, surgical data, and radiographic data were collected. The Gross equation and Sehat equation were used to calculate the estimated value of hidden blood loss. Multi-factor linear regression analysis was used to determine the influencing factors of hidden blood loss. Result We reviewed and collected 100 patients who underwent minimally invasive hybrid approach, mean age 65 ± 10 years, male: female 37:63; 17 patients of diabetes and 83 patients of non-diabetes; Total blood loss was 645.59 ± 376.37 ml, hidden blood loss was 421.39 ± 337.45 ml, the hidden blood loss percentage was 57 ± 26%. Results from the multi-factorial linear regression model: Diabetes (p < 0.05), hypertension (p < 0.05), psoas thickness (p < 0.05) and dorsal extensor group thickness (p < 0.05) were potential risk factors for postoperative hidden blood loss. Conclusion Although minimally invasive hybrid approach is minimally invasive surgery, there is still a significant amount of hidden blood loss. There is a greater risk of blood loss in diabetes, hypertension and preoperative MRI assessment of thickness of the psoas, thickness of the dorsal extensor group.
Background:Osteotomy and Orthopedics is the leading way to treat adult spinal deformity (ASD), but there are many surgical complications. meanwhile, oblique lumbar interbody fusion(OLIF) and anterior lumbar interbody fusion (ALIF) have becoming an increasingly popular surgical method of spinal surgery. Thus, the purpose of this study is to explore the feasibility and safety of minimally invasive anterior column realignment(ACR) in the treatment of adult spinal deformities. Methods:A total of 64 patients were included in the study. All patients received OLIF and/or ALIF and ACR, combined with Percutaneous pedicle screw fixation(PPSF). The surgical effect was evaluated by the operation time, bleeding volume, intervertebral space angle (IVA), lumbar lordosis (LL), the sagittal vertical axis (SVA), visual analog pain score (VAS), Japanese orthopedic association scores (JOA) and complications. Results: All patients completed 173 fusion segments; For 155 segments of ACR surgery, the average sagittal correction angle of each ACR segment was 15.3 ° ± 5.8 °. The mean preoperative and postoperative lumbar lordosis were, respectively, -16.7 ° ± 6.4 °and -48.6 ° ± 10.7 ° (p<0.001). JOA, VAS and other scores were significantly improved compared with those before operation. Conclusion: Anterior column realignment via a minimally invasive hybrid approach for adult spinal deformity can achieve good clinical outcome and deformity correction.
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