Locking Lumbar Interbody Cementation for Degenerative Scoliosis by Mini-Open or Percutaneous Approach

Purpose To report the results of locking lumbar interbody cementation (IBC) for the treatment of symptomatic Degenerative Lumbar Scoliosis (DLS). Methods Between Jan 2013 and Dec 2018, 62 patients with DLS received mini-open IBC under general anesthesia (OIBC) with 67.3±8.1 years and 98±10 month follow-up. Between 2019 and 2022, 32 DLS patients received percutaneous IBC under local anesthesia (PIBC) with 73.2 ± 8.0 years and 48±6 month follow-up. Patients with flexible DLS and fragile medical conditions were assigned to or percutaneous IBC under local anesthesia (PIBC). The clinical and radiological results and complications were retrospectively analyzed. Results The operative time of OIBC vs. The PIBC was 121 ± 26 vs. 80 ± 16 min, with an estimated blood loss of 196 ± 68 min. 18.0 ± 2 ml. Preoperative VAS and ODI were 7.9 ± 0.7 and 72.8 ± 8.7 vs. 7.7 ± 0.8 and 71.9 ± 8.6, respectively. At the final visit, VAS and ODI were 2.8 ± 1.1 and 24.3 ± 9.3 vs. 2.7 ± 1.2 and 24.7 ± 8.5. Preoperative Cobb's angles were 40.1° ± 14.6° vs. 18.8° ± 7.8° and 8.5° ± 7.4° vs. 3.7° ± 3.5° at the 24h follow-up and 14.6° ± 9.4° vs. 6.2° ± 4.4° at the final visit. Lumbar lordosis was corrected significantly in both groups. Asymptomatic cement leakage was common in 21 OIBC and 15 PIBC cases. 4 OIBC and 1 PIBC patients suffered minor perioperative complications. Two OIBC and one PIBC patients had symptomatic cement leakage and required revision surgery. Conclusions Both OIBC and PIBC showed significant improvements in clinical and radiological parameters. PIBC was good for polymorbid patients.