A study presented at the 2016 Society of Minimally Invasive Spine Surgery Annual Forum compared concave and convex approaches in lateral lumbar interbody fusion for scoliosis correction.
The study authors conducted a multicenter retrospective review of the MIS adult spinal deformity patients, with 420 included in the study. There were 165 patients with two-year data and 63 who underwent MIS reconstruction; 40 were approached from the concavity and 23 from the convexity side. The researchers found:
1. There weren’t any differences in the two groups in preoperative or postoperative radiographic parameters. The estimated blood loss, length of hospital stay and OR time were also similar.
2. Patients in both groups were treated at L4-5 with LLIF and reported similar LIV. The overall complications rates were also similar between the two groups, including rates for neurologic, vascular and visceral complications.
3. Eight neurologic complications appeared in the concavity group with one requiring reoperation and one needing revision of a pedicle screw. There was one neurologic complication in the convexity group.
4. Patients in both groups reported ODI, VAS back and leg score improvements and the improvements were similar in both groups.
5. The study authors concluded, “Patients undergoing cMIS surgery for adult degenerative scoliosis had equivalent complication rates, clinical and operative, with concave or convex LLIS approaches.”