Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion

Alluri, Ram K.; Mok, Jung; Vaishnav, Avani S.; Shelby, Tara; Sivaganesan, Ahilan; Hah, Raymond J.; Qureshi, Sheeraz A.

doi:10.14245/ns.2142440.220

Cited by 12 publications

(13 citation statements)

References 35 publications

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“…In general, there is a good body of literature discussing the occurrence of plexopathy following a direct lateral approach [ 26 , 27 ]. There is also literature to suggest that retractor time may be related to the rate of postoperative neural complications [ 28 , 29 ]. However, infection may pose a unique challenge.…”

Section: Discussionmentioning

confidence: 99%

Management of Refractory Post-operative Osteomyelitis and Discitis: A Case Report

DeLong,

Bashti,

et al. 2024

Cureus

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Vertebral osteomyelitis/discitis is a relatively rare disease but is a known potential complication of spinal surgical intervention. In general, the first-line treatment for this condition is targeted antibiotic therapy with surgical intervention only utilized in refractory cases with evidence of extensive damage, structural instability, or abscess formation. However, surgical best practices have not been established for osteomyelitis, including indications for anterior lateral interbody fusion (ALIF), posterior lateral interbody fusion (PLIF), or direct lateral interbody fusion (DLIF). This case provides a discussion of the indications that led to a direct lateral approach in the setting of refractory osteomyelitis/discitis, supporting factors that led to its success, and the efficacy of utilizing intraoperative neuromonitoring in cases of infection.

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Section: Discussionmentioning

confidence: 99%

Management of Refractory Post-operative Osteomyelitis and Discitis: A Case Report

DeLong,

Bashti,

et al. 2024

Cureus

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“…There are various surgical methods for treating spondylolisthesis, which can be broadly classified as ventral or dorsal approaches based on the direction of approach to the intervertebral disc space [3,10,17]. OLIF is a minimally invasive ventral approach that involves inserting a wide cage into the disc space [3,15,[18][19][20][21][22][23]. Unlike the trans-psoas approach, surgeons approach the disc space anterior to the psoas muscle in OLIF to minimize the risk of injury to the muscle and lumbosacral nerve plexus [4].…”

Section: Oblique Lumbar Interbody Fusionmentioning

confidence: 99%

Surgical treatment of spondylolisthesis by oblique lumbar interbody fusion and transpedicular screw fixation: Comparison between conventional double position versus navigation-assisted single lateral position

Han,

Ha,

Yuh

et al. 2023

PLoS ONE

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Background and objectives Oblique lumbar interbody fusion (OLIF) procedures involve anterior insertion of interbody cage in lateral position. Following OLIF, insertion of pedicle screws and rod system is performed in a prone position (OLIF-con). The location of the cage is important for restoration of lumbar lordosis and indirect decompression. However, inserting the cage at the desired location is difficult without reduction of spondylolisthesis, and reduction after insertion of interbody cage may limit the amount of reduction. Recent introduction of spinal navigation enabled both surgical procedures in one lateral position (OLIF-one). Therefore, reduction of spondylolisthesis can be performed prior to insertion of interbody cage. The objective of this study was to compare the reduction of spondylolisthesis and the placement of cage between OLIF-one and OLIF-con. Methods We retrospectively reviewed 72 consecutive patients with spondylolisthesis for this study; 30 patients underwent OLIF-one and 42 underwent OLIF-con. Spinal navigation system was used for OLIF-one. In OLIF-one, the interbody cage was inserted after reducing spondylolisthesis, whereas in OLIF-con, the cage was inserted before reduction. The following parameters were measured on X-rays: pre- and postoperative spondylolisthesis slippage, reduction degree, and the location of the cage in the disc space. Results Both groups showed significant improvement in back and leg pains (p < .05). Transient motor or sensory changes occurred in three patients after OLIF-con and in two patients after OLIF-one. Pre- and postoperative slips were 26.3±7.7% and 6.6±6.2% in OLIF-one, and 23.1±7.0% and 7.4±5.8% in OLIF-con. The reduction of slippage was 74.4±6.3% after OLIF-one and 65.4±5.7% after OLIF-con, with a significant difference between the two groups (p = .04). The cage was located at 34.2±8.9% after OLIF-one and at 42.8±10.3% after OLIF-con, with a significant difference between the two groups (p = .004). Conclusion Switching the sequence of surgical procedures with OLIF-one facilitated both the reduction of spondylolisthesis and the placement of the cage at the desired location.

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“…At 18 months follow-up, there was a decrease to 9.6% in sensory and 3.2% in motor symptoms [ 10 ]. With the development of advanced neuromonitoring techniques, evidence has shown a decrease in postoperative neurological deficits following lateral surgery [ 11 ]. Additional complications reported include rare wound infections, as well as visceral and vascular injury [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The Prone Lateral Approach for Lumbar Fusion—A Review of the Literature and Case Series

et al. 2023

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Lateral lumbar interbody fusion is an evolving procedure in spine surgery allowing for the placement of large interbody devices to achieve indirect decompression of segmental stenosis, deformity correction and high fusion rates through a minimally invasive approach. Traditionally, this technique has been performed in the lateral decubitus position. Many surgeons have adopted simultaneous posterior instrumentation in the lateral position to avoid patient repositioning; however, this technique presents several challenges and limitations. Recently, lateral interbody fusion in the prone position has been gaining in popularity due to the surgeon’s ability to perform simultaneous posterior instrumentation as well as decompression procedures and corrective osteotomies. Furthermore, the prone position allows improved correction of sagittal plane imbalance due to increased lumbar lordosis when prone on most operative tables used for spinal surgery. In this paper, we describe the evolution of the prone lateral approach for interbody fusion and present our experience with this technique. Case examples are included for illustration.

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Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion

Cited by 12 publications

References 35 publications

Management of Refractory Post-operative Osteomyelitis and Discitis: A Case Report

Management of Refractory Post-operative Osteomyelitis and Discitis: A Case Report

Surgical treatment of spondylolisthesis by oblique lumbar interbody fusion and transpedicular screw fixation: Comparison between conventional double position versus navigation-assisted single lateral position

The Prone Lateral Approach for Lumbar Fusion—A Review of the Literature and Case Series

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