Anterior column reconstruction of the lumbar spine in the lateral decubitus position: anatomical and patient-related considerations for ALIF, anterior-to-psoas, and transpsoas LLIF approaches

Buckland, Aaron J.; Ashayeri, Kimberly; León, Carlos; Cheng, Ivan; Thomas, J. Alex; Braly, Brett A.; Eisen, Leon

doi:10.1007/s00586-022-07127-9

Cited by 6 publications

(5 citation statements)

References 67 publications

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“…It should be noted that the process of puncturing and insertion of working cannula should be closely monitored under C‐arm fluoroscopy guidance. If the puncture position is too close to the ventral side, it increases the risk of abdominal organ and vascular injury as well as intraoperative irrigation water leakage leading to water intoxication 9 . Since all cages with poly‐ether‐ether‐ketone (PEEK) material contain metal locating pins, the estimated cutting area should be larger than the area where the locating pins are located.…”

Section: Discussionmentioning

confidence: 99%

“…If the puncture position is too close to the ventral side, it increases the risk of abdominal organ and vascular injury as well as intraoperative irrigation water leakage leading to water intoxication. 9 Since all cages with poly‐ether‐ether‐ketone (PEEK) material contain metal locating pins, the estimated cutting area should be larger than the area where the locating pins are located. Also, contact between the metal locating pins and the diamond head of high‐speed drill should be avoided to prevent damage to the instruments and iatrogenic injury to the soft tissue.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Resection and Decompression for Lateral Displacement of Cage after Oblique Lumbar Interbody Fusion: A Case Report from a Single Center

Xie

Zhu

Shen

et al. 2023

Orthopaedic Surgery

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BackgroundLateral displacement of cage is a rarely seen complication of oblique lumbar interbody fusion (OLIF). To the best of our knowledge, this complication has always been revised with posterior open surgery. However, open surgery often associates with large trauma and long period of recovery.Case PresentationIn the case presented, a 64‐year‐old male patient with lateral displacement of cage which consequently caused neurological symptoms after OLIF, was reported and surgically revised with an endoscopic resection and decompression technique. The surgery was performed through a posterolateral approach which was similar to transforaminal approach, with estimated blood loss of 45mL and whole operation time of 70 min. Neurological symptoms were disappeared after operation immediately and the patient was discharged 2 days later. He reported no symptoms other than mild weakness of the lower back at the last follow‐up of 12 months.ConclusionEndoscopic decompression technique may be an effective alternative to surgically treat lateral displacement of cage after OLIF with advantages of minimal invasion and quick recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Resection and Decompression for Lateral Displacement of Cage after Oblique Lumbar Interbody Fusion: A Case Report from a Single Center

Xie

Zhu

Shen

et al. 2023

Orthopaedic Surgery

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“…Patients were selected for transpsoas L4-L5 LLIF following thorough preoperative assessment as previously described including a physical examination, radiological and vascular assessment, psoas and lumbosacral plexus morphology, the height of the iliac crest relative to the L4-L5 disc, and the suitability for indirect decompression. 14 A comprehensive history was taken with emphasis on previous abdominal surgery, vascular conditions and procedures, and a history of malignancy including previous radiotherapy. Abdominal operations that require retroperitoneal dissection and abdominal or pelvic radiotherapy result in adhesions and retroperitoneal scarring, increasing the complexity of anterior spinal surgery due to difficulty mobilizing the peritoneum and great vessels.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Lateral lumbar interbody fusion at L4-L5 has a low rate of complications in appropriately selected patients when using a standardized surgical technique

Buckland,

Huynh,

Menezes

et al. 2024

Bone Joint J

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AimsThe aim of this study was to reassess the rate of neurological, psoas-related, and abdominal complications associated with L4-L5 lateral lumbar interbody fusion (LLIF) undertaken using a standardized preoperative assessment and surgical technique.MethodsThis was a multicentre retrospective study involving consecutively enrolled patients who underwent L4-L5 LLIF by seven surgeons at seven institutions in three countries over a five-year period. The demographic details of the patients and the details of the surgery, reoperations and complications, including femoral and non-femoral neuropraxia, thigh pain, weakness of hip flexion, and abdominal complications, were analyzed. Neurological and psoas-related complications attributed to LLIF or posterior instrumentation and persistent symptoms were recorded at one year postoperatively.ResultsA total of 517 patients were included in the study. Their mean age was 65.0 years (SD 10.3) and their mean BMI was 29.2 kg/m2 (SD 5.5). A mean of 1.2 levels (SD 0.6) were fused with LLIF, and a mean of 1.6 (SD 0.9) posterior levels were fused. Femoral neuropraxia occurred in six patients (1.2%), of which four (0.8%) were LLIF-related and two (0.4%) had persistent symptoms one year postoperatively. Non-femoral neuropraxia occurred in nine patients (1.8%), one (0.2%) was LLIF-related and five (1.0%) were persistent at one year. All LLIF-related neuropraxias resolved by one year. A total of 32 patients (6.2%) had thigh pain, 31 (6.0%) were LLIF-related and three (0.6%) were persistent at one year. Weakness of hip flexion occurred in 14 patients (2.7%), of which eight (1.6%) were LLIF-related and three (0.6%) were persistent at one year. No patients had bowel injury, three (0.6%) had an intraoperative vascular injury (not LLIF-related), and five (1.0%) had ileus. Reoperations occurred in five patients (1.0%) within 30 days, 37 (7.2%) within 90 days, and 41 (7.9%) within one year postoperatively.ConclusionLLIF involving the L4-L5 disc level has a low rate of persistent neurological, psoas-related, and abdominal complications in patients with the appropriate indications and using a standardized surgical technique.Cite this article: Bone Joint J 2024;106-B(1):53–61.

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Lateral decubitus single position anterior posterior surgery improves operative efficiency, improves perioperative outcomes, and maintains radiological outcomes comparable with traditional anterior posterior fusion at minimum 2-year follow-up

et al. 2023

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Anterior column reconstruction of the lumbar spine in the lateral decubitus position: anatomical and patient-related considerations for ALIF, anterior-to-psoas, and transpsoas LLIF approaches

Cited by 6 publications

References 67 publications

Endoscopic Resection and Decompression for Lateral Displacement of Cage after Oblique Lumbar Interbody Fusion: A Case Report from a Single Center

Endoscopic Resection and Decompression for Lateral Displacement of Cage after Oblique Lumbar Interbody Fusion: A Case Report from a Single Center

Lateral lumbar interbody fusion at L4-L5 has a low rate of complications in appropriately selected patients when using a standardized surgical technique

Lateral decubitus single position anterior posterior surgery improves operative efficiency, improves perioperative outcomes, and maintains radiological outcomes comparable with traditional anterior posterior fusion at minimum 2-year follow-up

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