title: Correction of Coronal Imbalance in Degenerative Lumbar Spine Disease Following Direct Lateral Interbody Fusion (DLIF).
abstract: OBJECTIVE
  The authors have recently been using a surgical technique of minimally invasive direct lateral interbody fusion (DLIF) for correcting of coronal imbalance. The purpose of this study was to evaluate the surgical outcome and complication of DLIF.
  
  
  METHODS
  We undertook retrospective analysis of a consecutive series of 8 DLIF procedures in Degenerative lumbar spine disease since May 2011. Four patients underwent DLIF only, and the others underwent combined DLIF and posterior fixation. Data on intra- and postoperative complications were collected. The pre- and postoperative X-rays were reviewed. We investigated coronal deformity, Cobb's angle, and apical vertebral translation (AVT). The mean follow-up period was months with a range of 2 to 8 months.
  
  
  RESULTS
  A mean preoperative coronal Cobb's angle was 21.8° (range 11.5-32.4°). Following after DLIF, the mean Cobb's angle was decreased to 13.0° (range 2.9-21.5°). Following additional posterior screw fixation, mean Cobb's angle was further decreased to 7.4° (range 2.9-13.2°). A mean preoperative AVT was 2.0 cm(range 0.6-3.5 cm), and improved to 1.4 cm(range 0.3-2.4 cm) and 0.8 cm(range 0.2-1.8 cm) postoperatively (DLIF and, posterior fixation respectively). One patient (12.5%) showed cage migration during follow-up period. Two patients (25%) developed motor weakness, and 4 patients (50%) experienced postoperative thigh paresthesias or dysesthesias. During follow up period, motor weakness had resolved in 1 patient. Sensory symptoms were improved in all patients at the last follow-up.
  
  
  CONCLUSIONS
  Degenerative lumbar disease can be effectively corrected by DLIF with acceptable complications.
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Severance Hospital, The Spine and Spinal Cord Institute, Seoul, Korea.
authors.forename: Ju Seong
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Severance Hospital, The Spine and Spinal Cord Institute, Seoul, Korea.
authors.forename: Hyo Sang
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Severance Hospital, The Spine and Spinal Cord Institute, Seoul, Korea.
authors.forename: Dong Ah
authors.initials: DA
authors.lastname: Shin
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Severance Hospital, The Spine and Spinal Cord Institute, Seoul, Korea.
authors.forename: Keung Nyun
authors.initials: KN
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Severance Hospital, The Spine and Spinal Cord Institute, Seoul, Korea.
authors.forename: Do Heum
authors.initials: DH
authors.lastname: Yoon
keywords: Coronal imbalance; DLIF; Degenerative lumbar disease; Lumbosacral plexus; Postoperative complication