Single position lateral decubitus anterior lumbar interbody fusion (ALIF) and posterior fusion reduces complications and improves perioperative outcomes compared with traditional anterior-posterior lumbar fusion

Ashayeri, Kimberly; León, Carlos; Tigchelaar, Seth; Fatemi, Parastou; Follett, M. P.; Cheng, Ivan; Thomas, J. Alex; Medley, Mark S.; Braly, Brett A.; Eisen, Leon; Protopsaltis, Themistocles S.; Buckland, Aaron J.

doi:10.1016/j.spinee.2021.09.009

Cited by 22 publications

(12 citation statements)

References 21 publications

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“… 6 , 7 There is evidence in the literature that using the anterior-lateral corridor to the spine results in less pain, better cosmesis, reduced postoperative ileus, and similar deformity correction and outcomes compared to surgery in the supine position. 4 , 6 , 9 , 10 From a technical perspective, LALIF offers all the benefits of an anterior approach to the spine, even in the presence of posterior instrumentation. 1 , 2 , 4 , 5 , 14 , 15 , 18 …”

Section: Discussionmentioning

confidence: 99%

“… 19 LALIF increases operating room efficiency by facilitating single-position surgery, especially when fusion at multiple lumbar levels is required. 6 , 7 , 9 , 10 , 19 It also enables direct visualization of neural, visceral, and vascular structures, which makes it safer compared to oblique and lateral approaches. Posterior instrumentation, if required, can also be achieved in the same setting, thus reducing operative and anesthesia time, operating room service use, and the risks involved with repositioning an anesthetized patient with a potentially unstable spine.…”

Section: Discussionmentioning

confidence: 99%

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Utilization of lateral anterior lumbar interbody fusion for revision of failed prior TLIF: illustrative case

Haider¹,

Wagner²,

Chandra³

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND The use of the lateral decubitus approach for L5–S1 anterior lumbar interbody fusion (LALIF) is a recent advancement capable of facilitating single-position surgery, revision operations, and anterior column reconstruction. To the authors’ knowledge, this is the first description of the use of LALIF at L5–S1 for failed prior transforaminal lumbar interbody fusion (TLIF) and anterior column reconstruction. Using an illustrative case, the authors discuss their experience using LALIF at L5–S1 for the revision of pseudoarthrosis and TLIF failure. OBSERVATIONS The patient had prior attempted L2 to S1 fusion with TLIF but suffered from hardware failure and pseudoarthrosis at the L5–S1 level. LALIF was used to facilitate same-position revision at L5–S1 in addition to further anterior column revision and reconstruction by lateral lumbar interbody fusion at the L1–2 level. Robotic posterior T10–S2 fusion was then added to provide stability to the construct and address the patient’s scoliotic deformity. No complications were noted, and the patient was followed until 1 year after the operation with a favorable clinical and radiological result. LESSONS Revision of a prior failed L5–S1 TLIF with an LALIF approach has technical challenges but may be advantageous for single position anterior column reconstruction under certain conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Utilization of lateral anterior lumbar interbody fusion for revision of failed prior TLIF: illustrative case

Haider¹,

Wagner²,

Chandra³

et al. 2022

Journal of Neurosurgery: Case Lessons

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“…Several studies have shown no significant differences in postoperative radiographic parameters between single and dual positioning. Furthermore, reduced operative time has been reported [ 15 , 16 , 17 , 18 ] in single-position patients as well as reduced fluoroscopy usage, EBL and rate of postoperative ileus. Although relatively efficient for instrumentation techniques, the lateral decubitus position does not allow for additional posterior procedures, such as direct neural decompression or osteotomies, for correction of spinal malalignment.…”

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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“…Lumbar spine spondylolisthesis is a common disease and is mostly caused by lumbar degeneration or spondylolysis. 1 Lumbar interbody fusion is the most commonly used treatment for lumbar spondylolisthesis, including posterior lumbar interbody fusion (PLIF) 2,3 , transforaminal lumbar interbody fusion (TLIF) 4,5 , anterior lumbar interbody fusion (ALIF) 6,7 , oblique lumbar interbody fusion (OLIF) 8-10 and so on. For L5 spondylolisthesis, many studies of PLIF, TLIF and ALIF were reported, but there was few studies of OLIF.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Transforaminal Endoscopic Surgery (PTES) and OLIF with Self-lock Cage through mini-incision for Surgical Treatment of L5 Spondylolisthesis

Zhou

Zhang

et al. 2022

Preprint

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Purpose: We designed Percutaneous Transforaminal Endoscopic Surgery (PTES) technique and OLIF with self-lock cage through mini-incision for the treatment of L5 spondylolisthesis. The purpose of study is to evaluate the feasibility, efficacy and safety of this method.Methods: Thirteen cases of L5 spondylolisthesis with nerve root symptoms were included in this study. PTES under local anesthesia, and then OLIF with self-lock cage and allograft under general anesthesia was performed. Back and leg pain were preoperatively and postoperatively evaluated using VAS, and the clinical outcomes were evaluated with ODI before surgery and at 2-year follow-up. Anterior and posterior intervertebral space height, lumbar lordotic angle, and operative segmental lordotic angle were measured on lumbar spine X-rays preoperatively and postoperatively. The fusion status was assessed according to the Bridwell’s fusion grades.Results: The VAS significantly dropped after surgery and the ODI decreased from 64.7±7.8% to 12.9±4.3% 2 years after surgery (p<0.001). Anterior and posterior intervertebral space height, and operative segmental lordotic angle significantly improved after surgery (p<0.05). Fusion grades based on the Bridwell grading system at 2-year follow-up were grade I in 9 segments (69.2%), grade II in 4 segments (30.8%). No patients had any form of permanent iatrogenic nerve damage and a major complication. No failure of instruments was observed.Conclusion: PTES and OLIF with self-lock cage is a good choice of minimally invasive surgery for L5 spondylolisthesis, which can get direct neurologic decompression and satisfying fusion, and hardly destroy the rectus abdominis and its sheath, paraspinal muscles and bone structures.

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Single position lateral decubitus anterior lumbar interbody fusion (ALIF) and posterior fusion reduces complications and improves perioperative outcomes compared with traditional anterior-posterior lumbar fusion

Cited by 22 publications

References 21 publications

Utilization of lateral anterior lumbar interbody fusion for revision of failed prior TLIF: illustrative case

Utilization of lateral anterior lumbar interbody fusion for revision of failed prior TLIF: illustrative case

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

Percutaneous Transforaminal Endoscopic Surgery (PTES) and OLIF with Self-lock Cage through mini-incision for Surgical Treatment of L5 Spondylolisthesis

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