Lateral lumbar interbody fusion: a systematic review of complication rates

Hijji, Fady Y.; Narain, Ankur S.; Bohl, Daniel D.; Ahn, Junyoung; Long, William W.; DiBattista, Jacob V.; Kudaravalli, Krishna T.; Singh, Kern

doi:10.1016/j.spinee.2017.04.022

Cited by 105 publications

(72 citation statements)

References 67 publications

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“…This percentage is similar to that reported previously. There have been several reports of the causes of these symptoms 16,18,19 . We believe that preventing blind dissection of the psoas muscle and minimizing the operation time required for LLIF may be effective for preventing these neurological complications 10 .…”

Section: Discussionmentioning

confidence: 99%

Short-term comparison of preoperative and postoperative pain after indirect decompression surgery and direct decompression surgery in patients with degenerative spondylolisthesis

Hiyama

Katoh

Sakai

et al. 2020

Sci Rep

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The purpose of this study was to compare the short-term clinical outcomes between extreme lateral interbody fusion (XLIF) and minimally invasive surgery (MIS)–transforaminal interbody fusion (TLIF) in patients with degenerative spondylolisthesis with stenosis. One hundred-six patients were enrolled; 44 were treated with MIS–TLIF (direct decompression group; DP), and 62 were treated with XLIF (indirect decompression group; IDP). Perioperative indexes included operation time and intraoperative bleeding. Perioperative indexes preoperative and postoperative numeric rating scale (NRS) scores for low back pain (NRS-BP), leg pain (NRS-LP), and leg numbness (NRS-LN), and the preoperative score on the Japanese version of the painDETECT questionnaire (PDQ-J) were also assessed. The average follow-up period for the collection of NRS scores was 12.6 months. The operation time was significantly shorter in the IDP than in the DP group (109.9 ± 35.4 vs. 153.3 ± 50.9 min; p < 0.001). Intraoperative blood loss was also significantly less in the IDP group than in the DP group (85.4 ± 125.4 vs. 258.3 ± 220.4 mL; p < 0.001). The PDQ-J score and preoperative NRS scores (NRS-BP, NRS-LP, and NRS-LN) did not differ significantly between groups. Less improvement in the NRS-BP (ΔNRS-BP) was observed in the DP group than in the IDP group (p < 0.05). Although pain improved after surgery in both groups, IDP surgery was advantageous in minimizing bleeding and preserving posterior support elements such as the facet joints, lamina, and paraspinal muscles. These findings suggest that this may have contributed to the higher rate of improvement in low back pain compared with DP surgery.

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Section: Discussionmentioning

confidence: 99%

Short-term comparison of preoperative and postoperative pain after indirect decompression surgery and direct decompression surgery in patients with degenerative spondylolisthesis

Hiyama

Katoh

Sakai

et al. 2020

Sci Rep

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“…Although minimally invasive lateral lumbar interbody fusion had the advantages of less muscular or ligamentous dissection, shorter hospital stay and faster recovery with good clinical outcomes [ 19 , 21 ], the high incidence of ipsilateral or contralateral nerve damage as well as major vascular complications were still reported by a number of clinical researches [ 3 , 13 , 23 , 25 ]. In order to reduce these complications, several anatomical researches have worked on the access corridor in relation to lateral approach [ 11 , 12 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Does the Access Angle Change the Risk of Approach-Related Complications in Minimally Invasive Lateral Lumbar Interbody Fusion? An MRI Study

Huang

Zhang

et al. 2018

J Korean Neurosurg Soc

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ObjectiveTo investigate the potential risk of approach-related complications at different access angles in minimally invasive lateral lumbar interbody fusion. MethodsEighty-six axial magnetic resonance images were obtained to analyze the risk of approach-related complications. The access corridor were simulated at different access angles and the potential risk of neurovascular structure injury was evaluated when the access corridor touching or overlapping the corresponding structures at each angle. Furthermore, the safe corridor length was measured when the corridor width was 18 and 22 mm. ResultsWhen access angle was 0°, the potential risk of ipsilateral nerve roots injury was 54.7% at L4–L5. When access angle was 45°, the potential risk of abdominal aorta, contralateral nerve roots or central canal injury at L4–L5 was 79.1%, 74.4%, and 30.2%, respectively. The length of the 18 mm-wide access corridor was largest at 0° and it could reach 44.5 mm at L3–L4 and 46.4 mm at L4–L5. While the length of the 22 mm-wide access corridor was 42.3 mm at L3–L4 and 44.1 mm at L4–L5 at 0°. ConclusionChanges in the access angle would not only affect the ipsilateral neurovascular structures, but also might adversely influence the contralateral neural elements. It should be also noted to surgeons that alteration of the access angle changed the corridor length.

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“…The necessity for aborting this procedure during the psoas transgression, especially for a highly degenerated and rotated L4-5 segment, is also a commonly reported experience. [27][28][29] ATP is a retroperitoneal approach based on dissection of the surgical corridor between the arterial axis (medial) and the psoas tendon (lateral). This corridor has been well described in different anatomical and morphological MRI studies, and it represents a safe path to lumbar discs.…”

Section: Discussionmentioning

confidence: 99%

The anterior-to-psoas approach for interbody fusion at the L5–S1 segment: clinical and radiological outcomes

Miscusi

Trungu

Ricciardi

et al. 2020

Neurosurgical Focus

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OBJECTIVEOver the last few decades, many surgical techniques for lumbar interbody fusion have been reported. The anterior-to-psoas (ATP) approach is theoretically supposed to benefit from the advantages of both anterior and lateral approaches with similar complication rates, even in L5–S1. At this segment, the anterior lumbar interbody fusion (ALIF) requires retroperitoneal dissection and retraction of major vessels, whereas the iliac crest does not allow the lateral transpsoas approach. This study aimed to investigate clinical-radiological outcomes and complications of the ATP approach at the L5–S1 segment in a single cohort of patients.METHODSThis is a prospective single-center study, conducted from 2016 to 2019. Consecutive patients who underwent ATP at the L5–S1 segment for degenerative disc disease or revision surgery after previous posterior procedures were considered for eligibility. Complete clinical-radiological documentation and a minimum follow-up of 12 months were set as inclusion criteria. Clinical patient-reported outcomes, such as the visual analog scale for low-back pain, Oswestry Disability Index, and 36-Item Short Form Health Survey (SF-36) scores, as well as spinopelvic parameters, were collected preoperatively, 6 weeks after surgery, and at the last follow-up visit. Intraoperative and perioperative complications were recorded. The fusion rate was evaluated on CT scans obtained at 12 months postoperatively.RESULTSThirty-two patients met the inclusion criteria. The mean age at the time of surgery was 57.6 years (range 44–75 years). The mean follow-up was 33.1 months (range 13–48 months). The mean pre- and postoperative visual analog scale (7.9 ± 1.3 vs 2.4 ± 0.8, p < 0.05), Oswestry Disability Index (52.8 ± 14.4 vs 22.9 ± 6.0, p < 0.05), and SF-36 (37.3 ± 5.8 vs 69.8 ± 6.1, p < 0.05) scores significantly improved. The mean lumbar lordosis and L5–S1 segmental lordosis significantly increased after surgery. The mean pelvic incidence–lumbar lordosis mismatch and pelvic tilt significantly decreased. No intraoperative complications and a postoperative complication rate of 9.4% were recorded. The fusion rate was 96.9%. One patient needed a second posterior revision surgery for residual foraminal stenosis.CONCLUSIONSIn the present case series, ATP fusion for the L5–S1 segment has resulted in valuable clinical-radiological outcomes and a relatively low complication rate. Properly designed clinical and comparative trials are needed to further investigate the role of ATP for different L5–S1 conditions.

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Lateral lumbar interbody fusion: a systematic review of complication rates

Cited by 105 publications

References 67 publications

Short-term comparison of preoperative and postoperative pain after indirect decompression surgery and direct decompression surgery in patients with degenerative spondylolisthesis

Short-term comparison of preoperative and postoperative pain after indirect decompression surgery and direct decompression surgery in patients with degenerative spondylolisthesis

Does the Access Angle Change the Risk of Approach-Related Complications in Minimally Invasive Lateral Lumbar Interbody Fusion? An MRI Study

The anterior-to-psoas approach for interbody fusion at the L5–S1 segment: clinical and radiological outcomes

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