*Article*

#### **Comparison of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion as Corrective Surgery for Patients with Adult Spinal Deformity—A Propensity Score Matching Analysis**

**Yu Matsukura 1, Toshitaka Yoshii 1,\*, Shingo Morishita 1, Kenichiro Sakai 2, Takashi Hirai 1, Masato Yuasa 1, Hiroyuki Inose 1, Atsuyuki Kawabata 1, Kurando Utagawa 1, Jun Hashimoto 1, Masaki Tomori 2, Ichiro Torigoe 2, Tsuyoshi Yamada 3, Kazuo Kusano 3, Kazuyuki Otani 3, Satoshi Sumiya 4, Fujiki Numano 4, Kazuyuki Fukushima 5, Shoji Tomizawa 6, Satoru Egawa 1, Yoshiyasu Arai 2, Shigeo Shindo 3 and Atsushi Okawa**


**Abstract:** Lateral lumbar interbody fusion (LLIF) is increasingly performed as corrective surgery for patients with adult spinal deformity (ASD). This paper compares the surgical results of LLIF and conventional posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) in ASD using a propensity score matching analysis. We retrospectively reviewed patients with ASD who received LLIF and PLIF/TLIF, and investigated patients' backgrounds, radiographic parameters, and complications. The propensity scores were calculated from patients' characteristics, including radiographic parameters and preoperative comorbidities, and one–to-one matching was performed. Propensity score matching produced 21 matched pairs of patients who underwent LLIF and PLIF/TLIF. All radiographic parameters significantly improved in both groups at the final follow-up compared with those of the preoperative period. The comparison between both groups demonstrated no significant difference in terms of postoperative pelvic tilt, lumbar lordosis (LL), or pelvic incidence–LL at the final follow-up. However, the sagittal vertical axis tended to be smaller in the LLIF at the final follow-up. Overall, perioperative and late complications were comparable in both procedures. However, LLIF procedures demonstrated significantly less intraoperative blood loss and a smaller incidence of postoperative epidural hematoma compared with PLIF/TLIF procedures in patients with ASD.

**Keywords:** adult spinal deformity (ASD); posterior lumbar interbody fusion; lateral lumbar interbody fusion; sagittal correction; perioperative complications; surgical invasiveness; degenerative adult deformity

**Citation:** Matsukura, Y.; Yoshii, T.; Morishita, S.; Sakai, K.; Hirai, T.; Yuasa, M.; Inose, H.; Kawabata, A.; Utagawa, K.; Hashimoto, J.; et al. Comparison of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion as Corrective Surgery for Patients with Adult Spinal Deformity—A Propensity Score Matching Analysis. *J. Clin. Med.* **2021**, *10*, 4737. https:// doi.org/10.3390/jcm10204737

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Academic Editor: Michael Sauerbier

Received: 30 August 2021 Accepted: 11 October 2021 Published: 15 October 2021

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**Copyright:** © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

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