Radiographic analysis of neuroforaminal and central canal decompression following lateral lumbar interbody fusion

Zheng, Bryan; Leary, Owen P.; Liu, David D.; Nuss, Sarah; Barrios-Anderson, Adriel; Darveau, Spencer C.; Syed, Sohail; Gokaslan, Ziya L.; Telfeian, Albert E.; Fridley, Jared; Oyelese, Adetokunbo A.

doi:10.1016/j.xnsj.2022.100110

North American Spine Society Journal (NASSJ)

2022

DOI: 10.1016/j.xnsj.2022.100110

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Radiographic analysis of neuroforaminal and central canal decompression following lateral lumbar interbody fusion

Bryan Zheng

Owen P. Leary

David D. Liu

et al.

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Cited by 4 publications

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“…The LLIF approach offers several advantages such as increased disc height restoration, indirect decompression of neural elements, larger cage footprint with apophyseal contact, and reduced morbidity with the advent of minimally invasive approaches (MIS). [1][2][3][4] Despite its advantages, traditional LLIFs have numerous drawbacks. LLIF surgery is traditionally described as being performed in a lateral decubitus position.…”

mentioning

confidence: 99%

“…Lateral lumbar interbody fusion (LLIF) is a well-established treatment option for deformity and degenerative spinal conditions. The LLIF approach offers several advantages such as increased disc height restoration, indirect decompression of neural elements, larger cage footprint with apophyseal contact, and reduced morbidity with the advent of minimally invasive approaches (MIS) 1–4 …”

mentioning

confidence: 99%

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Single-Position Prone Lateral Lumbar Interbody Fusion Increases Operative Efficiency and Maintains Safety in Revision Lumbar Spinal Fusion

Buckland

Proctor

Thomas³

et al. 2023

Spine

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Study Design. Multi-centre retrospective cohort study. Objective. To evaluate the feasibility and safety of the singleposition prone lateral lumbar interbody fusion (LLIF) technique for revision lumbar fusion surgery. Background Context. Prone LLIF (P-LLIF) is a novel technique allowing for placement of a lateral interbody in the prone position and allowing posterior decompression and revision of posterior instrumentation without patient repositioning. This study examines perioperative outcomes and complications of single position P-LLIF against traditional Lateral LLIF (L-LLIF) technique with patient repositioning. Method. A multi-centre retrospective cohort study involving patients undergoing 1 to 4 level LLIF surgery was performed at 4 institutions in the US and Australia. Patients were included if their surgery was performed via either: P-LLIF with revision posterior fusion; or L-LLIF with repositioning to prone. Demographics, perioperative outcomes, complications, and radiological outcomes were compared using independent samples t-tests and chi-squared analyses as appropriate with significance set at P < 0.05. Results. 101 patients undergoing revision LLIF surgery were included, of which 43 had P-LLIF and 58 had L-LLIF. Age, BMI and CCI were similar between groups. The number of posterior levels fused (2.21 P-LLIF vs. 2.66 L-LLIF, P = 0.469) and number of LLIF levels (1.35 vs. 1.39, P = 0.668) was similar between groups. Operative time was significantly less in the P-LLIF group (151 vs. 206 min, P = 0.004). EBL was similar between groups (150mL P-LLIF vs. 182mL L-LLIF, P = 0.31) and there was a trend toward reduced length of stay in the P-LLIF group (2.7 vs. 3.3d, P = 0.09). No significant difference was demonstrated in complications between groups. Radiographic analysis demonstrated no significant differences in preoperative or postoperative sagittal alignment measurements. Conclusion. P-LLIF significantly improves operative efficiency when compared to L-LLIF for revision lumbar fusion. No increase in complications was demonstrated by P-LLIF or trade-offs in sagittal alignment restoration.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Single-Position Prone Lateral Lumbar Interbody Fusion Increases Operative Efficiency and Maintains Safety in Revision Lumbar Spinal Fusion

Buckland

Proctor

Thomas³

et al. 2023

Spine

View full text Add to dashboard Cite

show abstract

“…Lateral lumbar interbody fusion (LLIF) may be considered in the treatment of symptomatic degenerative lumbar spinal stenosis (DLSS). With this background, Zheng et al performed a retrospective review of LLIF cases to quantify and assess radiographic metrics associated with such procedures 1 .…”

mentioning

confidence: 99%

“…With this background, Zheng et al. performed a retrospective review of LLIF cases to quantify and assess radiographic metrics associated with such procedures [1] .…”

mentioning

confidence: 99%

Commentary on “Radiographic analysis of neuroforaminal and central canal decompression following lateral lumbar interbody fusion”

Halperin¹,

Grauer²

2022

North American Spine Society Journal (NASSJ)

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Comparative analysis of changes in spinal dimensions following different correction methods in adult spinal deformity surgery

Dinh,

Ushirozako,

Hasegawa

et al. 2024

J Orthop Surg (Hong Kong)

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Background: Adult spinal deformity (ASD) surgery has gained popularity, with significant improvements in patient-reported outcomes. Posterior lumbar interbody fusion with multiple grade II osteotomies (PLIF + MOs) and lateral lumbar interbody fusion (LLIF) have been utilized to correct ASD; however, no studies have compared these methods with regard to the pre- and postoperative changes in length and volume of the spinal canal. This study aimed to investigate the 3-dimensional changes in the anterior vertical column length (AVCL), spinal canal length (SCL), and spinal canal volume (SCV) in patients with ASD after surgery, employing LLIF and PLIF + MOs. Methods: This retrospective study examined 44 patients with ASD who underwent surgery between 2010 and 2021 using two corrective surgical methods, LLIF and PLIF + MOs. Radiographic parameters and clinical outcomes were assessed, and three-dimensional models were created from computed tomography images to analyze changes in AVCL, SCL, and SCV. Results: We compared the effects of LLIF and PLIF + MOs on spinal canal dimensions during ASD surgery. LLIF demonstrated an increase in lumbar segment (L1-S1) AVCL and whole spine (T1-S1) SCL by 6.5 ± 8.0 mm and 13.8 ± 7.6 mm, respectively, compared with PLIF + MOs. However, PLIF + MOs exhibited a reduction in the lengths of the lumbar segment AVCL. Postoperative differences were significant for AVCL (L1-S1), SCL fusion level, and first-standing lumbar lordosis between the groups ( p < 0.0001, 0.002, and 0.016, respectively). LLIF significantly increased the SCV at the fusion level and whole spine T1-S1 by 14.5% and 10.6%, respectively, outperforming PLIF + MOs. Despite changes in dimensions, the postoperative Oswestry disability index scores showed no significant difference between the two groups. Conclusions: Our study suggests that LLIF can increase spinal canal space, lumbar lordosis, and anterior column length in the lumbar spinal segment. Knowledge of these variations may be critical for enhancing surgical outcomes and preventing neurological complications.

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Radiographic analysis of neuroforaminal and central canal decompression following lateral lumbar interbody fusion

Cited by 4 publications

References 30 publications

Single-Position Prone Lateral Lumbar Interbody Fusion Increases Operative Efficiency and Maintains Safety in Revision Lumbar Spinal Fusion

Single-Position Prone Lateral Lumbar Interbody Fusion Increases Operative Efficiency and Maintains Safety in Revision Lumbar Spinal Fusion

Commentary on “Radiographic analysis of neuroforaminal and central canal decompression following lateral lumbar interbody fusion”

Comparative analysis of changes in spinal dimensions following different correction methods in adult spinal deformity surgery

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