Anterior Column Realignment in Adult Spinal Deformity: A Case Report and Review of the Literature

Cheung, Zoe B.; Chen, Daniel H.; White, Samuel J.; Kim, Jun; Cho, Samuel K.

doi:10.1016/j.wneu.2018.11.174

Cited by 12 publications

(6 citation statements)

References 29 publications

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“…If necessary, percutaneous or open technology is used for posterior release and xation to complete lumbar lordosis reconstruction [19,20]. A systematic review by Cheung ZB [21], showed that at each ACR level, the increased range of focal segmental lordosis was 1-34 °, and the average improvement range of LL was 12.7-39 °. In our study, the average sagittal correction angle of each ACR segment was 15.3 °, lumbar lordosis increased by 31.9 °, and SVA improved from 65.1 mm to 29.5 mm.…”

Section: Discussionmentioning

confidence: 99%

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: an analysis of radiographic and clinical outcomes

Feng

Liu

Zhang

et al. 2023

Preprint

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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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Section: Discussionmentioning

confidence: 99%

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: an analysis of radiographic and clinical outcomes

Feng

Liu

Zhang

et al. 2023

Preprint

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show abstract

“…If necessary, percutaneous, or open technology is used for posterior release and fixation to complete lumbar lordosis reconstruction [ 20 , 21 ]. A systematic review by Cheung ZB [ 22 ], showed that at each ACR level, the increased range of focal segmental lordosis was 1–34°, and the average improvement range of LL was 12.7–39°. In our study, the average sagittal correction angle of each ACR segment was 10.3°, lumbar lordosis increased from 16.7° to 77.1°, and SVA improved from 65.1 mm to 29.5 mm.…”

Section: Discussionmentioning

confidence: 99%

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study

Feng,

Liu,

Zhang

et al. 2023

BMC Musculoskelet Disord

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Background Anterior column realignment (ACR) is a novel surgical method for correcting spinal sagittal balance. meanwhile, oblique lumbar interbody fusion (OLIF) and anterior lumbar interbody fusion (ALIF) are considered minimally invasive surgical methods through natural anatomical space. This study aimed to explore the corrective effects and clinical outcomes of OLIF or ALIF combined with ACR technology in patients with adult spinal deformity (ASD). Methods We retrospectively analyzed patients with sagittal imbalance who received OLIF and/or ALIF and ACR treatment from 2018 to 2021. Surgical time and intraoperative bleeding volume are recorded, the corrective effect is determined by the intervertebral space angle (IVA), lumbar lordosis (LL), the sagittal vertical axis (SVA), clinical outcome is evaluated by preoperative and final follow-up visual analog pain score (VAS), Japanese orthopedic association scores (JOA) and complications. Results Sixty-four patients were enrolled in the study, average age of 65.1(range, 47–82) years. All patients completed 173 fusion segments, for 150 segments of ACR surgery. The operation time of ALIF-ACR was 50.4 ± 22.1 min; The intraoperative bleeding volume was 50.2 ± 23.6 ml. The operation time and intraoperative bleeding volume of single-segment OLIF-ACR was 66.2 ± 19.4 min and 70.2 ± 31.6 ml. At the follow-up of 6 months after surgery, the intervertebral space angle correction for OLIF-ACR and ALIF-ACR is 9.2° and 12.2°, the preoperative and postoperative lumbar lordosis were 16.7° ± 6.4°and 47.1° ± 3.6° (p < 0.001), VAS and JOA scores were improved from 6.8 to 1.8 and 7.8 to 22.1 respectively, statistically significant differences were observed in these parameters. The incidence of surgical related complications is 29.69%, but without serious complications. Conclusion ACR via a minimally invasive hybrid approach for ASD has significant advantages in restoring local intervertebral space angulation and correcting the overall sagittal balance. Simultaneously, it can achieve good clinical outcomes and fewer surgical complications.

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“…Another review published in 2019 by Cheung et al . [ 17 ] is methodologically similar to our work but crucially differs in that it excludes all biomechanical models or cadaveric studies of ACR, which we wished to capture in our analysis to develop a full picture of how the study of ACR has evolved over time. Finally, a literature review and a technical description were included in a 2016 case series authored by Demirkiran et al .…”

Section: Discussionmentioning

confidence: 99%

Top-ten most-cited articles on anterior column release in the context of minimally invasive lumbar interbody fusion

Gohel

Patel

Lavadi

et al. 2023

J Craniovert Jun Spine

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Introduction: Lateral anterior column release (ACR) is a minimally invasive option for the correction of sagittal plane deformity. To assemble a homogeneous picture of published research on ACR, an advanced bibliometric analysis was conducted to compile the top-ten most-cited articles on the topic of ACR. Methods: A keyword search using the Thomson Reuters Web of Knowledge was conducted to identify articles discussing the role of lateral ACR. The articles were then ranked based on the total number of citations to identify the ten most-cited articles published. A subjective appraisal of the findings of these articles was conducted to provide a ranked literature review and to examine trends in the study of ACR between 2012 and 2019. Results: The earliest published article on ACR was in 2012 by Deukmedjian et al . Three articles were in vitro biomechanical assessments of ACR, and seven articles were on outcome analyses, which were either case series or case controlled. The most-cited article was a biomechanical study authored by Uribe et al . The article with the highest rate of citations/year was authored by Manwaring et al . Uribe and the European Spine Journal were the most frequently cited author and journal, respectively. Conclusions: The lateral ACR approach has enjoyed significant scholarly attention since its advent. Higher-level analyses with robust control groups, larger sample sizes, and long-term follow-up are necessary to improve our understanding of this approach.

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Anterior Column Realignment in Adult Spinal Deformity: A Case Report and Review of the Literature

Cited by 12 publications

References 29 publications

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: an analysis of radiographic and clinical outcomes

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: an analysis of radiographic and clinical outcomes

Anterior column realignment via a minimally invasive hybrid approach in adult spinal deformity surgery: a short-term retrospective study

Top-ten most-cited articles on anterior column release in the context of minimally invasive lumbar interbody fusion

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