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Minimally invasive surgery for adult spinal deformities (MIS deformity surgery) utilizes MIS lumbar interbody fusion and percutaneous pedicle screw fixation (PPSF) without posterior corrective osteotomy. While MIS reduces issues associated with open deformity surgery, it has limitations in correcting sagittal imbalance. This review discusses the limitations and solutions of lateral lumbar interbody fusion (LLIF) and introduces our experience in addressing marked sagittal deformities. We reviewed the literature and incorporated our clinical experience to evaluate the efficacy of recent MIS techniques, particularly focusing on oblique lumbar interbody fusion (OLIF) at L1-5 and L5-S1. The use of higher profile and greater angle cages and the application of PPSF with curved rods and percutaneous rod compression were discussed. Advances in MIS techniques, such as OLIF, have enabled significant improvements in increasing disc height and angle. Combining these new techniques and concepts, we successfully corrected marked sagittal deformities using MIS deformity surgery. Early onset of proximal junctional kyphosis was identified as a notable complication. Although recent advancements in MIS deformity surgery have shown promise in correcting sagittal deformities, further clinical experience and data are necessary to enhance outcomes and mitigate complications such as proximal junctional kyphosis.
Park et al. (Fri,) studied this question.