Fusion after minimally disruptive anterior lumbar interbody fusion: Analysis of extreme lateral interbody fusion by computed tomography

Rodgers, W. B.; Gerber, Edward J.; Patterson, Jamie

doi:10.1016/j.esas.2010.03.001

Cited by 77 publications

(43 citation statements)

References 43 publications

(31 reference statements)

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“…Furthermore, fusion rates and improvement in patient satisfaction have been on par with open techniques, ranging from 91-97% and 90%, respectively. 41,42 Despite the many benefits of this technique, it is far from a panacea for patients with lumbar degenerative pathology and is limited in several ways. Access to the L5-S1 disc space is limited given its location below the aortic bifurcation, which would require extensive vessel dissection.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

2015

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BackgroundLateral transpsoas interbody fusion (LTIF) is a minimally invasive technique for achieving lumbar spinal fusion. While it has many advantages over open techniques it carries with it a distinct set of risks, most commonly postoperative ipsilateral thigh pain, weakness and sensory disturbances. It is vital for both the surgeon and patient to understand the risks for and outcomes of injury associated with this procedure. We conducted a systematic review of the literature to evaluate the incidence, risks, and long-term clinical outcomes of post-operative thigh symptoms in patients treated with LTIF.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

2015

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“…further assessed fusion rates and patient outcomes in 66 patients one year after surgery; 96.6% of levels were judged as fused on CT scan, with nearly 90% of patients “satisfied or very satisfied.”[55] Complications other than those described in their previous reports were not discussed in this series. [5253]…”

Section: Results Of Xlif Surgerymentioning

confidence: 99%

The lateral transpsoas approach to the lumbar and thoracic spine: A review

2012

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Background:In the last several years, the lateral transpsoas approach to the thoracic and lumbar spine, also known as extreme lateral interbody fusion (XLIF) or direct lateral interbody fusion (DLIF), has become an increasingly common method to achieve fusion. Several recent large series describe several advantages to this approach, including less tissue dissection, smaller incisions, decreased operative time, blood loss, shorter hospital stay, reduced postoperative pain, enhanced fusion rates, and the ability to place instrumentation through the same incision. Indications for this approach have expanded and now include degenerative disease, tumor, deformity, and infection.Methods:A lateral X-ray confirms that the patient is in a truly lateral position. Next, a series of tubes and dilators are used, along with fluoroscopy, to identify the mid-position of the disk to be incised. After continued dilation, the optimal site to enter the disk space is the midpoint of the disk, or a position slightly anterior to the midpoint of the disk. XLIF typically allows for a larger implant to be inserted compared to TLIF or PLIF, and, if necessary, instrumentation can be inserted percutaneously, which would allow for an overall minimally invasive procedure.Results:Fixation techniques appear to be equal between XLIF and more traditional approaches. Some caution should be exercised because common fusion levels of the lumbar spine, including L4-5 and L4-S1, are often inaccessible. In addition, XLIF has a unique set of complications, including neural injuries, psoas weakness, and thigh numbness.Conclusion:Additional studies are required to further evaluate and monitor the short and long-term safety, efficacy, outcomes, and complications of XLIF procedures.

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“…29 Numerous retrospective cohort reviews exist that report the benefits of the lateral approach over historical controls or traditional interbody techniques including shorter operative times, minimal blood loss, and brief hospital stay with significant improvements in clinical and radiographic outcomes. [30][31][32][33][34][35] The potential for nerve root injury as a complication of interbody fusion is generally low but has been reported in the literature. Neurologic complications have been reported in 1 to 6.1% of open PLIFs.…”

Section: Current Concepts In Minimally Invasive Lumbar Interbody Fusionmentioning

confidence: 99%

True Percutaneous Transforaminal Lumbar Interbody Fusion: Case Illustrations, Surgical Technique, and Limitations

Syed

Voyadzis

2015

J Neurol Surg A Cent Eur Neurosurg

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Objective The last decade has seen significant advances in minimally invasive techniques for lumbar interbody fusion that have reduced approach-related morbidity. Percutaneous lumbar interbody fusion involves a posterior transforaminal approach to the disk space with a minimal access port through the Kambin triangle. This technique obviates the need for the facetectomy or laminectomy required in a traditional transforaminal approach. This article describes the surgical technique, potential advantages and limitations, and representative case illustrations. Methods Percutaneous transforaminal interbody fusion was performed on two patients with axial back and leg pain as a result of degenerative disk disease. Diskectomy and interbody cage insertion were completed through a tubular dilator placed onto the disk space in the Kambin triangle. Posterior fixation was achieved with percutaneous transfacet screws. Clinical outcome and postoperative complications are discussed. Results Both patients demonstrated significant clinical improvement after surgery with > 1 year follow-up despite experiencing transient neurologic symptoms. Conclusion Although this report demonstrates the feasibility and advantages of the approach, the technique is limited by the potential for nerve root injury and pseudoarthrosis.

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Fusion after minimally disruptive anterior lumbar interbody fusion: Analysis of extreme lateral interbody fusion by computed tomography

Cited by 77 publications

References 43 publications

Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

The lateral transpsoas approach to the lumbar and thoracic spine: A review

True Percutaneous Transforaminal Lumbar Interbody Fusion: Case Illustrations, Surgical Technique, and Limitations

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