Intertransverse Lumbar Interbody Fusion

Phillips, Frank M.; Cunningham, Benjamin

doi:10.1097/00007632-200201150-00019

Cited by 13 publications

(10 citation statements)

References 16 publications

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“…However, the procedures are relatively invasive as posterior interbody fusion techniques involve the need to manipulate the spinal canal, as a result of which dural tears or nerve injury can occur occasionally. [3] based on Wiltse's approach [9] in 2002. The approach in ELIF is from the posterolateral direction which is more lateral compared to those in PLIF or TLIF ( Figure 1A).…”

Section: Discussionmentioning

confidence: 99%

“…These techniques have produced stable outcomes but are relatively invasive because both the posterior muscles and spinal canal are surgically invaded. Therefore, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced [3]. In this technique, the approach is from the posterolateral direction, and the disc is manipulated through Kambin's safety triangle [4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

Shibayama¹,

Zhu

et al. 2020

Int J Spine Res

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

Shibayama¹,

Zhu

et al. 2020

Int J Spine Res

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“…The access to the intertransverse space is obstructed by the lateral part of the superior articular process of S1 and the medial portion of the sacral ala. ELIF was therefore considered not to be suitable at the L5-S1 level. 9,10 We propose a technique that makes ELIF surgery at the L5-S1 level feasible. The removal of a 2-to Unilateral foraminal stenosis and concomitant segmental instability 3-cm portion of the medial part of the sacral ala opened the working corridor to uncover the intervertebral disk from the lateral aspect of the spinal canal and to insert interbody fusion grafts without creating instability.…”

Section: Discussionmentioning

confidence: 99%

Extraforaminal Lumbar Interbody Fusion at the L5–S1 Level: Technical Considerations and Feasibility

Kurzbuch

Kaech

Baranowski³

et al. 2017

J Neurol Surg A Cent Eur Neurosurg

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Extraforaminal lumbar interbody fusion (ELIF) surgery is a muscle-sparing approach that allows the treatment of various degenerative spinal diseases. It is technical challenging to perform the ELIF approach at the L5-S1 level because the sacral ala obstructs the view of the intervertebral disk space. We reported earlier on the ELIF technique in which the intervertebral disk is targeted at an angle of 45 degrees relative to the midline. In this article we describe the technical process we developed to overcome the anatomic relation between the sacral ala and the intervertebral disk space L5-S1 that hinders the ELIF approach at this level. We then report in a retrospective analysis on the short-term clinical and radiologic outcome of 100 consecutive patients with degenerative L5-S1 pathologies who underwent ELIF surgery. The L5-S1 ELIF approach could be realized in all patients. The short-term clinical outcome was evaluated 5 months after surgery: 92% of the patients were satisfied with their postoperative result; 8% had a poor result. Overall, 17% of the patients presented light radicular or low back pain not influencing their daily activity, and 82% of the patients working before surgery returned to work 3 to 7 months after surgery. The radiologic outcome was documented by computed tomography at 5 months after surgery and showed fusion in 99% of the patients. Lumbar magnetic resonance imaging performed in 5 patients at 6 months after surgery revealed the integrity of the paraspinal muscles. ELIF surgery at the L5-S1 level is technically feasible for various degenerative spinal diseases. Analysis of the clinical and radiologic data in a consecutive retrospective cohort of patients who underwent this surgical procedure showed a good short-term clinical outcome and fusion rate.

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“…Much more has been written about traditional anterior approaches, which harbor the risks of major intraabdominal vessel injury, visceral injury, and postoperative ileus and in some cases retrograde ejaculation (12). Direct posterior approaches involve increased risks of neural injury through retraction, arachnoiditis, epidural fibrosis and postoperative spinal instability (9,13,14), while lateral/transpsoas approaches are complicated by injury to the lumbosacral plexus with various postoperative lumbar plexopathies reported (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…Originally described by Phillips and Cunningham, the intertransverse lumbar interbody fusion (ILIF) technique, though technical, has some inherent advantages (9). The approach avoids the need for an anterior dissection and its inherent risks in addition to avoiding disturbance of the spinal canal or neural foramen.…”

Section: Discussionmentioning

confidence: 99%

Feasibility, Risks, and Outcomes of Percutaneous Oblique Extraforaminal Lumbar Interbody Fusion Technique

Chin¹,

Pencle²,

Coombs³

et al. 2016

West Indian Med J

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Objective: To demonstrate the feasibility, risks and outcomes of percutaneous oblique extraforaminal lumbar interbody fusion (ELIF) technique. There is a growing interest in using less invasive and less exposure surgery techniques but very little has been written on an extraformainal approach for decompression and interbody fusion through Kambin's Triangle with the advantage of sparing the facets and lamina plus dissection of the multifidus muscles. Methods: We reviewed the medical records of 10 consecutive patients undergoing an extraforaminal approach to the lumbar disc space for placement of a cannulated and bulleted interbody cage for fusion followed by percutaneous transfacet pedicle screw fixation. The postoperative outcome scores and complications were obtained at the final follow up encounter were used to determine clinical improvement. Results: Mean age was 47.5 years and BMI was 29.8 kg/m 2 with males comprising 10% of the patient population. Three spinal levels were operated on including L3-L4, L4-L5, and L5-S1. Patients demonstrated improved VAS scores from a mean of 7.8 to 4, p= 0.001 and ODI decreased from 53% to 24.4 %, p= 0.02 at 24 months. Complications included three patients with postoperative neuropathy, one patient had a proud cage due to over packing of the disc space, and one patient had a nonunion and a subsequent revision. Conclusions: Results from this study show less than favorable overall outcome with 50% of patients experiencing neurological complications when using this extraforaminal approach. Operating on the L5-S1 level limits operating space and is not recommended for this approach.

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Intertransverse Lumbar Interbody Fusion

Cited by 13 publications

References 16 publications

Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

Extraforaminal Lumbar Interbody Fusion at the L5–S1 Level: Technical Considerations and Feasibility

Feasibility, Risks, and Outcomes of Percutaneous Oblique Extraforaminal Lumbar Interbody Fusion Technique

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