성균관대학교 의과대학 정형외과학교실
Lumbar degenerative scoliosis (LDS) has been increased with increased aging population. The conventional surgical treatment method of LDS was posterior decompression followed by lumbar fusion. However, these surgeries usually require long-level fusion with increased risk of much bleeding and perioperative morbidity especially in old patients. The correction of sagittal or coronal imbalance is also important in the surgical treatment of LDS, thus osteotomy may be sometimes required. Direct lateral interbody fusion (DLIF) has been introduced as a part of minimally invasive surgery. With DLIF technique, the stenotic canal or foramen can be decompressed indirectly without laminectomy and the lumbar lordosis can be restored through the disc height distraction. Recently, DLIF has been also used for the surgical treatment of LDS. With use of DLIF for LDS, it has been reported that the lumbar lordosis and coronal curve angle were restored and the clinical outcome was also favorable without significant surgical morbidities. The lateral approach sometimes carries the risk of the lumbar plexus palsy or vessel injuries. DLIF can be a good alternative to the posterior fusion technique for the treatment of LDS in that it can minimize the perioperative morbidity and it can also restore the sagittal or coronal radiographic profiles effectively.
