Less invasive corrective surgery using oblique lateral interbody fusion (OLIF) including L5-S1 fusion for severe lumbar kyphoscoliosis due to L4 compression fracture in a patient with Parkinson’s disease: a case report

Abstract

BACKGROUND: Corrective surgery for kyphoscoliosis patients tend to be highly invasive due to osteotomy. The present case introduce less invasive corrective surgery using anterior oblique lateral interbody fusion (OLIF) technique. CASE PRESENTATION: An 80-year-old Japanese man with a history of Parkinson's disease presented to our hospital because of severe kyphoscoliosis and gait disturbance. Considering the postsurgical complications due to osteotomy, we performed an anterior-posterior combined corrective fusion surgery: OLIF of Lumbar (L) 2-3, L3-4, and L4-5 (Medtronic Sofamor Danek, Memphis, TN, USA) followed by L5-Sacral (S) 1 anterior lumbar fusion via the OLIF approach using an anterior intervertebral cage, and posterior L3-4 and L4-5 facetectomy and posterior fusion using percutaneous pedicle screws from Thoracic (T) 10 to S1 with a T-9 hook system. The surgery was performed in a less invasive manner with no osteotomy, and it improved the sagittal alignments with moderate restoration, which improved the patient's posture and gait disturbance. The patient showed transient muscle weakness of proximal lower extremity contralateral side to the surgical site, which fully recovered by physical rehabilitation 3 months after the surgery. CONCLUSION: The surgical corrective procedure using the minimally invasive OLIF method including L5-S1 fusion showed a great advantage in treating degenerative kyphoscoliosis in a Parkinson's disease patient in its less-invasive approac.