Oblique lateral interbody fusion with prioritized core vertebral correction technology for the treatment of lumbosacral curve-driven degenerative lumbar scoliosis.

Abstract

Objective: This study aims to assess the effectiveness of oblique lateral interbody fusion, which prioritizes the correction of core distance, in comparison to traditional posterior surgery, in patients with lumbosacral curve-driven degenerative lumbar scoliosis.

Methods: This retrospective study analyzed consecutive patients with lumbosacral curve-driven degenerative lumbar scoliosis at a single institution from January 2019 to December 2023. The patients were divided into two groups: the traditional posterior approach group (n = 55) (Group T) and the prioritized core vertebral correction technology group (n = 52) (Group P-CV). Preoperative and postoperative data were analyzed using the SRS-22r score and imaging. To further illustrate the significance of prioritizing the core distance, a correlation analysis was conducted between the core distance and preoperative as well as postoperative coronal parameters.

Results: There was no significant difference in preoperative baseline data between two groups (P>0.05). Preoperative core distance was correlated with L4 tilt, L5 tilt, thoracolumbar Cobb, Aa, and CBD (P<0.05). Compared with Group T, intraoperative changes in core distance, change of core distance/preoperative core distance, CBD, Aa, and lumbosacral Cobb were greater in Group P-CV than in Group T. Similarly, postoperative CBD, Aa, L4 tilt, L5 tilt, core distance, and lumbosacral Cobb were smaller in Group P-CV than in Group T (P<0.05). The changes in core distance and core distance/preoperative core distance were correlated with postoperative CBD (-0.529, -0.771, P<0.05). Group P-CV had shorter operation time, less intraoperative blood loss, and fewer surgical segments (P<0.05).

Conclusion: The core vertebrae of patients with lumbosacral curve-driven degenerative lumbar scoliosis can be identified by distance measurement. Oblique lateral interbody fusion with prioritized core vertebral correction technology can effectively prevent coronal imbalance after surgery, thereby improving the lumbosacral curve. This technique provides a safe and effective approach for treating lumbosacral curve-driven degenerative lumbar scoliosis.