Adult Degenerative Scoliosis Treated With XLIF Clinical and Radiographical Results of a Prospective Multicenter Study With 24-Month Follow-up

1Midwest Orthopaedics at Rush University Medical Center, Chicago, IL 2Division of Neurosurgery, Duke University Medical Center, Durham, NC 3Spine Midwest, Inc., Jefferson City, MO 4Georgia Spine and Neurosurgery Center, Decatur, GA 5INSPIRE Research Foundation, Decatur, GA 6Northwest Orthopaedic Specialists, Spokane, WA 7University of California San Francisco, San Francisco, CA 8Southern Oregon Orthopedcis, Medford, OR 9South Florida Spine Institute, Miami Beach, FL.
Spine (Impact Factor: 2.3). 07/2013; 38(21). DOI: 10.1097/BRS.0b013e3182a43f0b
Source: PubMed


Study Design: Prospective, multi-center, single-arm study.Objective: The objective of this study was to evaluate the clinical and radiographic results of patients undergoing a minimally disruptive lateral transpsoas retroperitoneal surgical approach (XLIF) for the treatment of degenerative scoliosis (DS).Summary of Background Data: Surgery for the treatment of DS has been reported to have acceptable results but is traditionally associated with high morbidity and complication rates. A minimally disruptive lateral transpsoas retroperitoneal surgical approach (XLIF) has become popular for the treatment of DS. This is the first prospective, multi-center study to quantify outcomes following XLIF in this patient population.Methods: 107 patients with DS who underwent the XLIF procedure with or without supplemental posterior fixation at one or more intervertebral levels were enrolled in this study. Clinical and radiographic results were evaluated up to 24 months after surgery.Results: Mean patient age was 68 years; 73% of patients were female. A mean of 3.0 (range 1-6) levels were treated with XLIF per patient. Overall complication rate was low compared with traditional surgical treatment for DS. Significant improvement was seen in all clinical outcome measures at 24 months: ODI, VAS back, VAS leg, SF-36 MCS and PCS (p<0.001). Eighty-five percent of patients were satisfied with their outcome and would undergo the procedure again. In hypolordotic patients, lumbar lordosis was corrected from a mean of 27.7° to 33.6° at 24 months (p<0.001). Overall Cobb angle was corrected from 20.9° to 15.2° with the greatest correction observed in patients supplemented with bilateral pedicle screws.Conclusion: The current study demonstrates the utility of the XLIF procedure in the treatment of DS. XLIF is associated with good clinical and radiographic outcomes with a substantially lower complication rate than has been reported with traditional surgeries.

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