Osteotomies through a fusion mass in the lumbar spine

Vital, Jean-Marc; Boissière, Louis; Bourghli, Anouar; Castelain, Jean-Etienne; Challier, Vincent; Obeid, Ibrahim

doi:10.1007/s00586-014-3657-4

Cited by 5 publications

(1 citation statement)

References 16 publications

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“…Moreover, achievement of proper L4-S1 lordosis according to Roussouly's classification is fundamental [11]. Conventional posterior strategies involving osteotomies of the fusion mass are technically demanding due to scar tissue and involve high rates of complications [15]. In case of high amount of sagittal correction needed three-column osteotomies (3-CO) such as standard pedicle subtraction osteotomies (PSO), hypercomplex PSO or corner osteotomies are widely described strategies in the literature [16,17].…”

Section: Discussionmentioning

confidence: 99%

Anterior Lumbar Interbody Fusion (ALIF) L5-S1 with overpowering of posterior lumbosacral instrumentation and fusion mass: a reliable solution in revision spine surgery

et al. 2021

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Background and purposeIn cases of spine surgical revisions of patients affected by sagittal malalignment, the restoration of the ideal lumbar lordosis (LL) is mandatory. ALIF procedures represent a powerful and effective approach to improve the LL in case of hypolordosis. This study evaluates the feasibility of ALIF to overpower posterior lumbar instrumentation and fusion mass in revision spine surgery and secondarily to estimate complications, clinical and radiological outcomes. Methods This is a single-center retrospective analysis of prospectively collected data on the use of ALIF overpowering in cases of lumbosacral instrumentation and/or fusion. Demographic, comorbidity, corrective strategy adopted, surgical data, clinical and radiological results, and intraoperative and postoperative complications were recorded. Results Twelve patients (3 male; 9 female) underwent overpowering ALIF L5-S1 were included in the study with a mean FU of 34.0 ± 13.4 months. In 10 cases, a posterior titanium instrumentation and fusion mass were present; in 2 patients, only a fusion mass was present. Indicators of pain and disability improved in all patients (p < 0.01). Sagittal realignment with the restoration of ideal spinopelvic parameters was obtained in all cases. One peritoneal lesion requiring intraoperative suture without sequelae, two cases of postoperative radiculopathy, and one posterior wound infection requiring surgical debridement and antibiotic therapy were reported. Conclusions Anterior implant of lordotic and hyperlordotic cages with increasing segmental lordosis is possible in the presence of posterior instrumentation and/or solid fusion mass. The biomechanical strength of this corrective technique can overcome posterior instrumentation and bone fusion resistance, therefore allowing a single-staged surgery for sagittal realignment.

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Section: Discussionmentioning

confidence: 99%

Anterior Lumbar Interbody Fusion (ALIF) L5-S1 with overpowering of posterior lumbosacral instrumentation and fusion mass: a reliable solution in revision spine surgery

et al. 2021

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Erweiterte transforaminale lumbale intersomatische Fusion zur Korrektur kyphotisch fixierter lumbaler Segmente und lumbaler Hypolordosen

Lattig

Stettin

Weckbach

2018

Oper Orthop Traumatol

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In all, 25 patients with 33 kyphotic fixed lumbar segments were treated using a complete anterior release of the annulus and anterior longitudinal ligament via a unilateral transforaminal approach. This enabled a lordosizing correction of the segment between 5° and 29° (mean 11.4°) without any neurological or vascular complications. A total of 10 patients treated with an additional posterior osteotomy were corrected 14-29° (mean 19°). There was a loss of reduction of the lordotic correction (mean 1°; range 0-3°) in the X‑ray control at a minimum follow-up of 6 months (range 6-33 months).

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102 lumbar pedicle subtraction osteotomies: one surgeon’s learning curve

et al. 2018

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PSO technique has a relatively long learning curve. This study showed that accumulating the experience over the years, while performing cases on a regular basis, is definitely the key in mastering this complex and risky technique, with significant improvements in the perioperative parameters that directly impact the recovery and global outcome. These slides can be retrieved under Electronic Supplementary Material.

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Osteotomies through a fusion mass in the lumbar spine

Cited by 5 publications

References 16 publications

Anterior Lumbar Interbody Fusion (ALIF) L5-S1 with overpowering of posterior lumbosacral instrumentation and fusion mass: a reliable solution in revision spine surgery

Anterior Lumbar Interbody Fusion (ALIF) L5-S1 with overpowering of posterior lumbosacral instrumentation and fusion mass: a reliable solution in revision spine surgery

Erweiterte transforaminale lumbale intersomatische Fusion zur Korrektur kyphotisch fixierter lumbaler Segmente und lumbaler Hypolordosen

102 lumbar pedicle subtraction osteotomies: one surgeon’s learning curve

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