Lee-Onn Chieng

By Mick Perez-Cruet and Lee-Onn Chieng

Substantial evidence exists supporting lumbar fusion procedures in cases of spondylolysis, spondylolisthesis, and other cases of sagittal deformity. However, coronal deformity can also be a cause of low back and leg pain. One hundred seven patients underwent minimally invasive transforaminal lumbar interbody fusion (MITLIF). All patients had preoperative and postoperative radiographs exhibiting a clear coronal deformity that correlated with their symptomatology. Dynamic radiographs were analyzed using a three-point angle measurement tool through the EasyViz viewer program. Pre-op and post-op Cobb angles (CA) were recorded along with Health-related Quality of Life (HRQL) measures, Visual Analog Scale, Oswestry Disability Index, and SF-36. The average CA decreased from 9.47 pre-op to 7.54 post-op (p < 0.05). CA ranged from 0.7 to 43.2% pre-op, and 0.7 to 34.1% post-op. There was a statistically significant (p < 0.05) correlation between CA improvement and HRQL measure improvement. There has not been an appropriate level of focus on coronal deformity, its relationship to HRQL measures, and long-term prognosis. In our study, CA was reduced by 21% on average with just a single-level fusion, supporting the consideration of a focused single-level fusion versus a large multilevel fusion in cases of coronal deformity, especially in elderly patients.

Part of the book: Adult and Pediatric Spinal Deformities