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

Abstract

Introduction Up to now, there were few studies on extreme lateral interbody fusion (XLIF) surgery for lumbar spondylodiscitis. This study was aimed to evaluate clinical effectiveness and provide more information for XLIF in the treatment of lumbar spondylodiscitis. Methods We retrospectively collected cases of XLIF for the treatment of lumbar spondylodiscitis from September 2017 to February 2020. There were 8 cases of non-specific infection of lumbar spine, 4 cases of lumbar tuberculosis, and 1 case of lumbar brucellosis. Basic information, antibiotic application, and inflammatory index were collected before and after surgery. Clinical effectiveness was evaluated at baseline and in 3, 6, and 12 months after the surgery with visual analog scale (VAS) and Oswestry disability index (ODI). The comparison of the indicators before and after the operation was performed by repeated measures analysis of variance. Results The average intraoperative blood loss and operation time was 70mL and 99.23 min, respectively. The study consisted of 13 cases with single segment operation. The average follow-up time was 16.54 months. No sign of recurrence of spondylodiscitis occurred at last follow-up. Postoperative VAS and ODI were significantly decreased after the operation. No major blood vessels, nerves, or organ damage occurred during the perioperative period. Conclusion XLIF has shown good clinical effectiveness in the treatment of lumbar spondylodiscitis with advantages of less bleeding and less tissue damage in the present study. More multi-center prospective comparative studies are needed to further verify the clinical effectiveness of this procedure in lumbar spondylodiscitis.