MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics

Lehmen, Jeff A.; Gerber, Edward J.

doi:10.1007/s00586-015-3886-1

Cited by 89 publications

(41 citation statements)

References 249 publications

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“…8 There were 9 approach-related complications noted in our cohort. These predominantly consisted of mild, transient paresthesia and hip flexion weakness.…”

Section: Discussionmentioning

confidence: 93%

Use of 3D CT-based navigation in minimally invasive lateral lumbar interbody fusion

Joseph¹,

Smith²,

Patel

et al. 2016

SPI

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OBJECTIVE Lateral lumbar interbody fusion (LLIF) is an increasingly popular technique used to treat degenerative lumbar disease. The technique of using an intraoperative cone-beam CT (iCBCT) and an image-guided navigation system (IGNS) for LLIF cage placement has been previously described. However, other than a small feasibility study, there has been no clinical study evaluating its accuracy or safety. Therefore, the purpose of this study was to evaluate the accuracy and safety of image-guided spinal navigation in LLIF. METHODS An analysis of a prospectively acquired database was performed. Thirty-one consecutive patients were identified. Accuracy was initially determined by comparison of the planned trajectory of the IGNS with post–cage placement intraoperative fluoroscopy. Accuracy was subsequently confirmed by postprocedural CT and/or radiography. Cage placement was graded based on a previously described system separating the disc space into quarters. RESULTS The mean patient age was 63.9 years. A total of 66 spinal levels were treated, with a mean of 2.1 levels (range 1–4) treated per patient. Cage placement was noted to be accurate using IGNS in each case, as confirmed with intraoperative fluoroscopy and postoperative imaging. Sixty-four (97%) cages were placed within Quarters 1 to 2 or 2 to 3, indicating placement of the cage in the anterior or middle portions of the disc space. There were no instances of misguidance by IGNS. There was 1 significant approach-related complication (psoas muscle abscess) that required intervention, and 8 patients with transient, mild thigh paresthesias or weakness. CONCLUSIONS LLIF can be safely and accurately performed utilizing iCBCT and IGNS. Accuracy is acceptable for multilevel procedures.

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“…8 There were 9 approach-related complications noted in our cohort. These predominantly consisted of mild, transient paresthesia and hip flexion weakness.…”

Section: Discussionmentioning

confidence: 93%

Use of 3D CT-based navigation in minimally invasive lateral lumbar interbody fusion

Joseph¹,

Smith²,

Patel

et al. 2016

SPI

View full text Add to dashboard Cite

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“…Benefits of LLIF include decreased postoperative pain, shorter hospital stay, and faster return to ordinary daily living. However, several complications peculiar to LLIF have been reported; these complications include damage to blood and lymphatic vessels, nerves, ureters, and viscera, sometimes causing sexual dysfunction, experienced after an anterior approach 1,[6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Integrated anatomy of the neuromuscular, visceral, vascular, and urinary tissues determined by MRI for a surgical approach to lateral lumbar interbody fusion in the presence or absence of spinal deformity

Ebata

Ohba

Haro

2018

Spine Surg Relat Res

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Introduction: To comprehensively investigate the anatomy of the neuromuscular, visceral, vascular, and urinary tissues and their general influence on lateral lumbar interbody fusion (LLIF) surgery in the presence or absence of spinal deformity.Methods: We retrospectively reviewed 100 consecutive surgery cases for lumbar degenerative disease of patients aged on average 70.5 years and of which 67 were women. A sagittal vertical axis deviation of more than 50 mm was defined as adult spinal deformity (ASD: 50 patients). The degenerative disease of the other patients was defined as lumbar spinal stenosis (LSS: 50 patients). We analyzed the relative anatomical position of the psoas major muscle, lumbar plexus, femoral nerves, inferior vena cava, abdominal aorta and its bifurcation, ureter, testicular or ovarian artery, kidney and transverse abdominal muscle in patients with ASD or with LSS, using preoperative magnetic resonance imaging (MRI).Results: For patients with ASD, the L4-5 intervertebral disk was closer to the lumbar nerve plexus than it was in those with LSS (p < 0.0001), and a rising psoas sign at the L4-5 disk was significantly more frequent in patients with ASD than in those with LSS (p < 0.05). The aortic bifurcation frequently appeared at the level of L4-5 in patients with either degenerative disease, so the common iliac artery may pass near the disk. The inferior vena cava passed closer to the center of the L4-5 disk in patients with ASD than it did in those with LSS (p < 0.05). The transverse abdominal muscle at L2-3, L3-4, and L4-5 was closer to and less than 3 mm from the kidneys in many more patients with ASD than was the case for patients with LSS (p = 0.3, p < 0.05, p = 0.29, respectively).Conclusions: We recommend careful preoperative MRI to determine the location of organs to help to avoid intraoperative complications during LLIF surgery, especially for patients with ASD.

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“…[1][2][3][4][5][6][7][8][9][10][11][12] However, given the inherent axial and coronal stability of a large anterolateral cage, the structural necessity of invasive/extensive PSF in ALIF/LLIF has come into question, particularly in single-level application. Accordingly, a growing body of literature exploring less invasive and less demanding alternatives for secondary stability in ALIF/LLIF has emerged.…”

Section: Introductionmentioning

confidence: 99%

Anterior and Lateral Lumbar Interbody Fusion With Supplemental Interspinous Process Fixation: Outcomes from a Multicenter, Prospective, Randomized, Controlled Study

et al. 2018

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MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics

Cited by 89 publications

References 249 publications

Use of 3D CT-based navigation in minimally invasive lateral lumbar interbody fusion

Use of 3D CT-based navigation in minimally invasive lateral lumbar interbody fusion

Integrated anatomy of the neuromuscular, visceral, vascular, and urinary tissues determined by MRI for a surgical approach to lateral lumbar interbody fusion in the presence or absence of spinal deformity

Anterior and Lateral Lumbar Interbody Fusion With Supplemental Interspinous Process Fixation: Outcomes from a Multicenter, Prospective, Randomized, Controlled Study

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