Is laparoscopic approach to lumbar spine fusion worthwhile?

Katkhouda, Namir; Campos, Guilherme M.; Mavor, Eli; Mason, Rodney J.; Hume, Mary; Ting, Alvin

doi:10.1016/s0002-9610(99)00229-9

Cited by 20 publications

(13 citation statements)

References 7 publications

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“…They felt that the L4−L5 LALIF was very difficult if not im− possible, because of the left iliac vein and inferior vena cava that lie directly over the disc space. Authors of another two studies shared a similar view [3,7].…”

Section: The L4−l5 Lalifmentioning

confidence: 66%

Laparoscopic Anterior Lumbar Interbody Fusion: A Review of Outcome Studies

Inamasu

Guiot

2005

Minim Invasive Neurosurg

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Laparoscopic anterior lumbar interbody fusion (LALIF) was first reported in 1995. It was expected to reduce the morbidity of an open ALIF, while maintaining its advantages. About a decade after its debut, the feasibility and short-term efficacy of the LALIF has been recognized. Currently, other minimally-invasive surgical options have been made available for the treatment of lumbar degenerative disc disease, and thus the role of LALIF has not been established in view of these other methods. The authors aim to clarify this, by conducting a review of the literature particularly on the outcome studies of LALIF. Several comparative studies showed that at the L5-S1 disc level, there was no marked difference between LALIF and the open or mini-open ALIF in terms of short-term efficacy, i. e., operative time, blood loss, and length of hospital stay. With regard to the complication rate, however, there was a higher incidence of retrograde ejaculation in LALIF. At the L4-L5 and L4-L5/L5-S1 disc levels, the complication rate and conversion rate to open surgery was high in LALIF, and many authors were not impressed with the LALIF at these levels. Several case series showed that the LALIF yielded excellent perioperative outcomes in the hands of experienced endoscopic spine surgeons at both the L5-S1 and L4-L5 disc levels. No conclusion regarding either the superiority or inferiority of LALIF to the open or mini-open ALIF can be drawn, because of the lack of data with a high-level of evidence. It cannot be denied, however, that some spine surgeons are abandoning this procedure and switching to the mini-open ALIF. Treatment of lumbar degenerative disc disease itself has been changing rapidly, as represented by the recent emergence of the lumbar artificial disc, and the future role of LALIF remains to be followed closely.

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Section: The L4−l5 Lalifmentioning

confidence: 66%

Laparoscopic Anterior Lumbar Interbody Fusion: A Review of Outcome Studies

Inamasu

Guiot

2005

Minim Invasive Neurosurg

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“…Comparative study of laparoscopic L5-S1 fusion versus open mini-ALIF, with a minimum 2-year follow-up vessels [8,12,24,26]. Usually the spine surgeon cannot reach the anterior aspect of lumbar spine without the help of a laparoscopic surgeon.…”

Section: Sang Ki Chung Sang Ho Lee Sang Rak Lim Dong-yun Kim Jee Soo mentioning

confidence: 99%

Comparative study of laparoscopic L5?S1 fusion versus open mini-ALIF, with a minimum 2-year follow-up

Chung

Lee

Lim

et al. 2003

European Spine Journal

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Anterior lumbar interbody fusion (ALIF) is a widely accepted tool for management of painful degenerative disc disease. Recently, the modern laparoscopic surgical technique has been combined with ALIF procedure, with good early postoperative results being reported. However, the benefit of laparoscopic fusion is poorly defined compared with its open counterpart. This study aimed to compare perioperative parameters and minimum 2-year follow-up outcome for laparoscopic and open anterior surgical approach for L5-S1 fusion. The data of 54 consecutive patients who underwent anterior lumbar interbody fusion (ALIF) of L5-S1 from 1997 to 1999 were collected prospectively. More than 2-years' follow-up data were available for 47 of these patients. In all cases, carbon cage and autologous bone graft were used for fusion. Twenty-five patients underwent a laparoscopic procedure and 22 an open mini-ALIF. Three laparoscopic procedures were converted to open ones. For perioperative parameters only, the operative time was statistically different (P=0.001), while length of postoperative hospital stay and blood loss were not. The incidence of operative complications was three in the laparoscopic group and two in the open mini-ALIF group. After a follow-up period of at least 2 years, the two groups showed no statistical difference in pain, measured by visual analog scale, in the Oswestry Disability Index or in the Patient Satisfaction Index. The fusion rate was 91% in both groups. The laparoscopic ALIF for L5-S1 showed similar clinical and radiological outcome when compared with open mini-ALIF, but significant advantages were not identified, despite its technical difficulty.

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“…Minimally invasive spinal surgery improves cosmesis and decreases postoperative pain, morbidity, hospital stay, and recovery time [2,7,11]. Although this approach is well suited for the L5±S1 disc level, the proximity of the bifurcation of the great vessels has limited enthusiasm for the anterior approach to the L4± L5 disc level [4].…”

Section: Discussionmentioning

confidence: 99%

“…These authors converted 1 patient secondary to dense adhesions between the iliac vein bifurcation and the L4± L5 annulus. Katkhouda et al [4] reported 9 cases of L4± L5 fusions. Three cases were single fusions of L4±L5 and 6 cases were multiple-level fusions including the L4±L5 disc level.…”

Section: Discussionmentioning

confidence: 99%