Direct lateral interbody fusion with indirect decompression of the spinal roots in patients with degenerative lumbar spinal stenosis

Abstract

Introduction Degenerative spine conditions involve the gradual loss of normal structure of the spine among the population and remain a common form of work-limiting health condition in 80 % of the population. The demand for surgical interventions will remain high in an aging population to improve quality of life. Lumbar spinal decompression and stabilization are produced using ventral, posterior and lateral approaches. Lateral lumbar interbody fusion (LLIF) is used for treatment of degenerative lumbar stenosis having advantages over surgical interventions from other approaches.The objective was to determine the prospects of LLIF as an independent decompressive and stabilizing surgical intervention using literature data.Material and methods This article presents generalized information from Russian and foreign publications on LLIF with indirect decompression of the lumbar nerve roots. The original literature search was conducted on key resources including Scientific Electronic Library (www.elibrary.ru), the National Library of Medicine (www.pubmed.org) and Scopus using keywords: direct lateral interbody fusion, indirect decompression of the spinal nerve roots, predictors, lateral lumbar interbody fusion, direct lumbar interbody fusion, extreme lumbar interbody fusion, indirect decompression. The review included 60 articles published between 1998 and 2023 inclusive.Results and discussion After performing LLIF, some patients experience indirect decompression of the spinal nerve roots to prevent epidural fibrosis, injury to the dura mater and spinal nerve roots. Identifying a model of patients with degenerative spinal stenosis who can undergo LLIF as an independent decompressivestabilizing surgical intervention without additional instrumentation can improve the effectiveness of surgical treatment.Conclusion LLIF was shown to be an effective method for indirect decompression of spinal nerve roots at the intervertebral foramina. Indirect decompression of the spinal nerve roots in the spinal canal may fail and the choice of a LLIF candidate (a single surgical intervention) remains open.