Can XLIF Surgery Treat the Lumbar Spine Infection?

Abstract

Hematogenous vertebral osteomyelitis has increased in recent years, likely due to longer life expectancies, higher prevalence of chronic disease, better diagnostic techniques, and more frequent use of indwelling intravascular catheters and immunosuppressive therapy [1]. Vertebral osteomyelitis represents 2% to 7% of all cases of osteomyelitis and approximately 50% with spine infections are older than 50 years, and two thirds are male [2]. It is associated with significant morbidity, including prolonged antimicrobial therapy, risk of recurrence, and decreased functional status. Staphylococcus aureus is among the most common organisms causing hematogenous vertebral osteomyelitis [1]. Medical management is the first choice to spondylodiscitis, patients who fail antibiotic therapy and bracing, or present with instability, significant deformity, neurologic deficits, or sepsis, were required operative debridement and stabilization [2]. ALIF (anterior lumbar interbody fusion), PLIF (posterior lumbar interbody fusion) and TLIF (transforaminal lumbar interbody fusion) were performed to treat lumbar spondylodiscitis respectively to achieve rather good clinical results but also causing much morbid [3-7].

Clinical experience of extreme lateral interbody fusion in the treatment of lumbar spondylodiscitis

“…To date, only few studies have reported that XLIF was used to treat lumbar spondylodiscitis. [15][16][17][18][19] However, the current research studies only simply summarized the technology and lacked the evaluation of the clinical effectiveness of this surgical treatment for lumbar spondylodiscitis. This study reviewed the cases of lumbar spondylodiscitis treated by XLIF in our center to evaluate the clinical effectiveness.…”

“…Up to now, all the studies on XLIF in the treatment of lumbar infection were case series studies. Research studies by Blizzard et al, 15 Patel et al, 19 and He et al 18 were all brief introduction of this clinical application without clinical evaluation. Timothy et al 16 included 11 cases of non-specific lumbar infection and 3 cases of lumbar tuberculosis, and VAS and ODI improved by 3.0 (95% CI, 1.7-4.4) and 40 (95% CI, 10-52), respectively, at the last follow-up (range 41-93 months) after XLIF.…”

“…13,14 However, there were few studies on XLIF surgery for lumbar spondylodiscitis. [15][16][17][18][19] Moreover, there was a lack of evaluation on the clinical effect of this application. This study retrospectively collected our center's application of XLIF in the treatment of lumbar spondylodiscitis to evaluate clinical effectiveness and provide more information for XLIF in the treatment of lumbar spondylodiscitis.…”