Simultaneous Anterior and Posterior Release in Lateral Decubitus Position for Rigid Adult Spinal Deformity: A Technical Note and 2 Case Reports.
Adult spinal deformity
Lateral decubitus position
Navigation
Release
Simultaneous
Single-position surgery
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
received:
13
11
2021
revised:
11
12
2021
accepted:
13
12
2021
pubmed:
24
12
2021
medline:
21
4
2022
entrez:
23
12
2021
Statut:
ppublish
Résumé
Correction surgery for rigid adult spinal deformity usually involves a complex 360° osteotomy, multiple intraoperative position changes, and staged surgery. Moreover, there is a lack of consensus regarding the surgical strategy for this pathology. We report the technical advantages of a simultaneous anterior and posterior release only in the lateral decubitus position to reduce surgical invasiveness in two case reports. A 76-year-old woman and an 80-year-old woman presented with significant spinal imbalance and segmental fusion in the anterior and posterior columns around the apex of the lumbar spinal curvature. We conducted this procedure for these patients at the first stage of spinal corrective surgery to achieve 360° osteotomy. A long posterior fusion surgery was performed after 1 week. The mean values of the central sacral vertical line, pelvic incidence minus lumbar lordosis, sagittal vertical axis, and pelvic tilt improved substantially postoperatively: central sacral vertical line, from 51.0 to 7.5 mm; pelvic incidence minus lumbar lordosis, from 27.5° to 0.5°, sagittal vertical axis, from 107.6 to 14 mm; pelvic tilt, from 34.0° to 13.0°. The mean surgical time and blood loss in the first- and second-stage operations were 242.1 minutes and 702 mL and 315.5 minutes and 549 mL, respectively, and no perioperative complications occurred. Simultaneous 360° segmental release in the lateral decubitus position without repositioning can make it possible to acquire satisfactory correction and reduce surgical invasiveness compared with the conventional procedure for adult spinal deformity.
Sections du résumé
BACKGROUND
Correction surgery for rigid adult spinal deformity usually involves a complex 360° osteotomy, multiple intraoperative position changes, and staged surgery. Moreover, there is a lack of consensus regarding the surgical strategy for this pathology. We report the technical advantages of a simultaneous anterior and posterior release only in the lateral decubitus position to reduce surgical invasiveness in two case reports.
CASE DESCRIPTION
A 76-year-old woman and an 80-year-old woman presented with significant spinal imbalance and segmental fusion in the anterior and posterior columns around the apex of the lumbar spinal curvature. We conducted this procedure for these patients at the first stage of spinal corrective surgery to achieve 360° osteotomy. A long posterior fusion surgery was performed after 1 week. The mean values of the central sacral vertical line, pelvic incidence minus lumbar lordosis, sagittal vertical axis, and pelvic tilt improved substantially postoperatively: central sacral vertical line, from 51.0 to 7.5 mm; pelvic incidence minus lumbar lordosis, from 27.5° to 0.5°, sagittal vertical axis, from 107.6 to 14 mm; pelvic tilt, from 34.0° to 13.0°. The mean surgical time and blood loss in the first- and second-stage operations were 242.1 minutes and 702 mL and 315.5 minutes and 549 mL, respectively, and no perioperative complications occurred.
CONCLUSIONS
Simultaneous 360° segmental release in the lateral decubitus position without repositioning can make it possible to acquire satisfactory correction and reduce surgical invasiveness compared with the conventional procedure for adult spinal deformity.
Identifiants
pubmed: 34942390
pii: S1878-8750(21)01891-X
doi: 10.1016/j.wneu.2021.12.048
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
40-47Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.