Extreme lateral interbody fusion (XLIF) in a consecutive series of 72 patients

Abstract

Extreme lateral interbody fusion (XLIF) has become the standard of minimally invasive lumbar segmental scoliosis treatment. Our objective is to determine the safety and efficacy of XLIF in spinal canal stenosis (SCS) and spondylodiscitis (SD). Patients treated with XLIF in our department between 2012 and 2018 were retrospectively analyzed. Patient records with clinical and radiographical parameters were evaluated. The patient cohort consists of 40 male and 32 female patients with a median age of 66.6 years. Forty-five patients had an SCS and 27 patients SD. The mean follow-up was 23 months. One level XLIF was performed in 49 patients, 2 levels in 15, 3 levels in 7 patients and 4 levels in 1 patient. All but one patient received an additional dorsal stabilization. The pain was present in all patients with a mean Visual Analogue Scale (VAS) score of 8.8 vs. postoperative VAS of 2.8 (p<0.05). Preoperative neurological deficits were found in 44 patients. Only 6 patients had a neurological deterioration, 45 patients improved, and 21 patients remained unchanged. One patient experienced a perioperative complication. Non-fusion occurred in 8 cases. There were no outcome differences regarding pain and radiological outcome between patients with SCS and SD as well as between patients with one level vs. multilevel surgery. Baseline characteristics and the radiological outcome did not differ between the two groups. Patients with SD had a higher rate of worsening of neurological deficits following surgery, a higher rate of non-fusion, and a longer hospital stay. Patients with spinal canal stenosis SCS had a longer surgery time and more frequent adjacent segment disease.

Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis

“…Consistent with our research, Pojskic et al .’s experiment showed that the VAS improved after XLIF, which dropped from 8.8 to 2.8. 26 In Chen's research, the JOA score increased from 12 to 18.9, showing the same trend as our report. 27 It can be seen that XLIF is an effective operation for the treatment of lumbar degenerative diseases.…”

“…The VAS of leg pain and JOA score improved significantly after operation in all groups and no difference was identified among the three groups at all time points, which showed the good effect of XLIF operation on nerve decompression. Consistent with our research, Pojskic et al .’s experiment showed that the VAS improved after XLIF, which dropped from 8.8 to 2.8 26 . In Chen's research, the JOA score increased from 12 to 18.9, showing the same trend as our report 27 .…”

Treatment of lumbar brucella spondylitis with negative pressure wound therapy via extreme lateral approach: A case report

“…Particularly for the surgical treatment of lumbar vertebra infection, the extreme lateral approach can directly reach and thoroughly expose the lesion space and vertebral body. Simultaneously, the spinal canal, spinal cord, and dura can be avoided, making the surgery safer ( 15 ). During this surgery, we directly exposed the intervertebral space of the lesion with a highly lateral approach, without harming the facet joints and compromising the spine's stability.…”

Management of Refractory Post-operative Osteomyelitis and Discitis: A Case Report

“…The most commonly noted deficit was ipsilateral thigh weakness, most frequent in spondylodiscitis patients, which the authors attributed to paravertebral muscle infection, rather than due to the DLIF approach itself. The authors also noted a higher rate of non-fusion when utilizing the DLIF approach, also attributed to infection, as well as shorter follow-up [ 16 ]. These collective findings underscore the need for formal guidelines for employing the DLIF approach in refractory osteomyelitis/discitis cases.…”