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

Abstract 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.