Clinical evaluation of microendoscopy-assisted extreme lateral interbody fusion

Segawa, Tomio; Inanami, Hirohiko; Koga, Hisashi

doi:10.21037/jss.2017.08.09

Cited by 6 publications

(12 citation statements)

References 13 publications

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“…To address these complications, we have previously reported the advantages of microendoscopy-assisted XLIF over conventional XLIF [19]. In addition, the use of microendoscopy has been implemented to assist operative procedures since the introduction of OLIF at our hospital.…”

Section: Introductionmentioning

confidence: 99%

Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Segawa¹,

Koga²,

Oshina³

et al. 2021

Medicina

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Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

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Section: Introductionmentioning

confidence: 99%

Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Segawa¹,

Koga²,

Oshina³

et al. 2021

Medicina

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“…A total of 42 articles were eventually included in our systematic review [1, 3–5, 7–9, 11, 13–15, 17, 19–25, 27–30, 32, 33, 36–41, 43–46, 49, 51, 52, 55, 56, 59, 60]. Two studies were level II evidence [19, 52], seven were level III evidence [11, 24, 32, 46, 49, 56, 59], and the remaining were level IV evidence (Fig.…”

Section: Resultsmentioning

confidence: 99%

Lateral Lumbar Interbody Fusion: What Is the Evidence of Indirect Neural Decompression? A Systematic Review of the Literature

et al. 2020

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Background: In the past decade, lateral lumbar interbody fusion (LLIF) has gained in popularity. A proposed advantage is the achievement of indirect neural decompression. However, evidence of the effectiveness of LLIF in neural decompression in lumbar degenerative conditions remains unclear. Questions/Purposes: We sought to extrapolate clinical and radiological results and consequently the potential benefits and limitations of LLIF in indirect neural decompression in degenerative lumbar diseases. Methods: We conducted a systematic review of the literature in English using the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. Scores on the Oswestry Disability Index (ODI) and visual analog scale (VAS) for back and leg pain were extracted, as were data on the following radiological measurements: disc height (DH), foraminal height (FH), foraminal area (FA), central canal area (CA). Results: In the 42 articles included, data on 2445 patients (3779 levels treated) with a mean follow-up of 14.8 ± 5.9 months were analyzed. Mean improvements in VAS back, VAS leg, and ODI scale scores were 4.1 ± 2.5, 3.9 ± 2.2, and 21.9 ± 7.2, respectively. Post-operative DH, FH, FA, and CA measurements increased by 68.6%, 21.9%, 37.7%, and 29.3%, respectively. Conclusion: Clinical results indicate LLIF as an efficient technique in indirect neural decompression. Analysis of radiological data demonstrates the effectiveness of symmetrical foraminal decompression. Data regarding indirect decompression of central canal and lateral recess are inconclusive and contradictory. Bony stenosis appears as an absolute contraindication. The role of facet joint degeneration is unclear. This systematic review provides a reference for surgeons to define the potential and limitations of LLIF in indirect neural elements decompression.Keywords lateral lumbar interbody fusion . indirect neural decompression . lumbar stenosis . outcomes . extreme lateral interbody fusion . lumbar degenerative diseases

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“…[8] Utilizing micro endoscopy in 96 patients undergoing 1-3 level MI XLIF for lumbar stenosis/ scoliosis, Segawa et al (2017) found no injuries to the segmental arteries. [12] Of the 1995 XLIF studied over 2 years by Fujibayashi et al (2017), the overall complication rate was 18%, and included a 0.03% incidence of major vascular injuries. [7] Amongst Paterakis et al (2018) study involving 12 XLIF, complications included no major vascular injuries.…”

Section: Major Vascular Complications In Small/larger Case Series Of Xlif/mi Xlifmentioning

confidence: 98%

“…The incidence of major vascular injuries occurring for transpsoas XLIF/MI XLIF performed in the 5 small and larger case series involving a total of 6,732 patients (range from 12 to 4,607 patient/series) ranged from 0% (3 studies) to 0.03% (1 study) to 0.4% (1 study) [Table 1]. [7,8,10,12,13] Karikari et al (2011), evaluated 22 MI Thoracic/Thoracolumbar XLIF involving 47 levels; the 3 adverse events did not include any vascular injuries [Table 1]. [8] Utilizing micro endoscopy in 96 patients undergoing 1-3 level MI XLIF for lumbar stenosis/ scoliosis, Segawa et al (2017) found no injuries to the segmental arteries.…”

Section: Major Vascular Complications In Small/larger Case Series Of Xlif/mi Xlifmentioning

confidence: 99%

“…[7,8,10,12,13] Karikari et al (2011), evaluated 22 MI Thoracic/Thoracolumbar XLIF involving 47 levels; the 3 adverse events did not include any vascular injuries [Table 1]. [8] Utilizing micro endoscopy in 96 patients undergoing 1-3 level MI XLIF for lumbar stenosis/ scoliosis, Segawa et al (2017) found no injuries to the segmental arteries. [12] Of the 1995 XLIF studied over 2 years by Fujibayashi et al (2017), the overall complication rate was 18%, and included a 0.03% incidence of major vascular injuries.…”

Section: Major Vascular Complications In Small/larger Case Series Of Xlif/mi Xlifmentioning

confidence: 99%

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Incidence of Major Vascular Injuries with Extreme Lateral Interbody Fusion (XLIF)

Epstein¹

2020

Surgical Neurology International

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Background: Extreme lateral interbody fusions (XLIF) and minimally invasive (MI) XLIF theoretically offer wide access to the lumbar disc space. The theoretical advantages of XLIF include; minimally disturbing surrounding structures (e.g. neural, vascular, soft-tissue), while offering stability. In addition to the well-known increased frequency of neurological deficits attributed to XLIF, here we explored how often major vascular injures occur with XLIF/MI XLIF procedures. Methods: In 13 XLIF/MI XLIF studies, we evaluated the frequency of major vascular injuries. Results: The studies citing the different frequencies of vascular injuries associated with XLIF/MI XLIF were broken down into three categories. Of the 5 small and larger case series, involving a total of 6,732 patients (e.g. range of 12 to 4,607 patients/study), the incidence of vascular injuries ranged from 0% (3 studies) up to 0.4%. Three case reports presented major vascular injuries attributed to XLIF/MI XLIF. Two involved the L4-L5 level. The three complications included: one fatal injury, one, a retroperitoneal hematoma with hemorrhagic shock, and one major vascular injury. For the 5 review articles, major vascular complications were just discussed in 2, one study cited 3 specific major vascular injuries (e.g. 1 fatal, 1 life threating, and 1 lumbar artery pseudoaneurysm requiring embolization), while 2 other studies stated the frequency of these injuries was 0.4% for XLIF, and 1.7 % for OLIF (Oblique Lumbar Interbody Fusion). Conclusions: According to 5 small and larger case series, 3 case reports, and 5 review articles, the incidence of major vascular injuries occurring during XLIF/MI XLIF ranges from 0 to 0.03% to 0.4%.

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Clinical evaluation of microendoscopy-assisted extreme lateral interbody fusion

Cited by 6 publications

References 13 publications

Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Lateral Lumbar Interbody Fusion: What Is the Evidence of Indirect Neural Decompression? A Systematic Review of the Literature

Incidence of Major Vascular Injuries with Extreme Lateral Interbody Fusion (XLIF)

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