Lateral interbody fusion combined with open posterior surgery for adult spinal deformity

Strom, Russell G.; Bae, Jang–Ho; Mizutani, Jun; Valone, Frank H.; Ames, Christopher P.; Deviren, Vedat

doi:10.3171/2016.4.spine16157

Cited by 61 publications

(42 citation statements)

References 37 publications

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“…Interestingly, in this study, the authors found better clinical outcomes, less EBL, fewer complications, and faster recovery in the hybrid group (LLIF and open posterior surgery) compared to the group with open posterior surgery alone [37].…”

Section: Discussionmentioning

confidence: 55%

Lateral Lumbar Interbody Fusion—Outcomes and Complications

Salzmann

Shue

Hughes

2017

Curr Rev Musculoskelet Med

119

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Purpose of Review Lateral lumbar interbody fusion (LLIF) is a relatively new, minimally invasive technique for interbody fusion. The goal of this review is to provide a general overview of LLIF with a special focus on outcomes and complications. Recent Findings Since the first description of the technique in 2006, the indications for LLIF have expanded and the rate of LLIF procedures performed in the USA has increased. LLIF has several theoretical advantages compared to other approaches including the preservation of the anterior and posterior annular/ligamentous structures, insertion of wide cages resting on the dense apophyseal ring bilaterally, and augmentation of disc height with indirect decompression of neural elements. Favorable long-term outcomes and a reduced risk of visceral/vascular injuries, incidental dural tears, and perioperative infections have been reported. However, approach-related complications such as motor and sensory deficits remain a concern. Summary In well-indicated patients, LLIF can be a safe procedure used for a variety of indications.

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Section: Discussionmentioning

confidence: 55%

Lateral Lumbar Interbody Fusion—Outcomes and Complications

Salzmann

Shue

Hughes

2017

Curr Rev Musculoskelet Med

119

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“…Anterior column release (ACR) is a powerful surgical technique for achieving spinopelvic balance in adult patients with sagittal plane deformities (Park et al, ; Turner et al, ; Demirkiran et al, ; Hamilton et al, ; Saigal et al, ; Strom et al, ; Than et al, ; Mundis et al, ; Theologis et al, ). ACR is performed through a lateral approach or through an anterior approach with intervertebral diskectomy and release of the anterior longitudinal ligament (ALL), followed by placement of a hyperlordotic interbody device.…”

Section: Introductionmentioning

confidence: 99%

“…A second‐stage posterior approach is typically performed to further stabilize the construct; posterior column osteotomies are often utilized during the posterior approach to maximize correction. The posterior approach has been described using both open and minimally invasive techniques (Park et al, ; Turner et al, ; Strom et al, ; Than et al, ; Mundis et al, ). Numerous studies have demonstrated that ACR can produce comparable lordotic correction as posterior‐only three‐column osteotomies (3CO), with similar complication profiles and less blood loss (Park et al, ; Turner et al, ; Demirkiran et al, ; Hamilton et al, ; Saigal et al, ; Strom et al, ; Than et al, ; Mundis et al, ; Theologis et al, ).…”

Section: Introductionmentioning

confidence: 99%

Posterior open‐wedge anterior longitudinal ligament release: Cadaveric technique analysis

Bohl

Hlubek

et al. 2018

Clinical Anatomy

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Anterior column release is a powerful surgical technique for achieving spinopelvic balance in adult patients with sagittal plane deformities. We present an alternative strategy for focal deformity correction from a posterior-only approach. The purpose of this study was to evaluate the feasibility and efficacy of a novel surgical technique called posterior open-wedge diskectomy and anterior longitudinal ligament (ALL) release (POWAR). A cadaveric torso underwent POWARs at the L1-L4 intervertebral disc spaces. Baseline measurements of end-plate angle (EPA), anterior intervertebral disc height (ADH), and posterior intervertebral disc height (PDH) were obtained. These measurements were repeated after three stages of correction: posterior column compression alone, posterior column compression following Schwab grade 2 osteotomies, and posterior column compression following POWAR. A second cadaver underwent posterolateral spinal dissection to demonstrate the pertinent anatomical features relevant to this novel procedure. With each stage of correction, a sequential increase in EPA and ADH and a decrease in PDH were demonstrated. The large increase in ADH seen following POWAR confirmed successful release of the ALL. In situ investigation of the aorta and inferior vena cava following anterior exposure revealed no injury to the great vessels or surrounding structures. Ex vivo testing of the aorta and inferior vena cava took place at the L3-4 level. This testing demonstrated no injury or tears to either vessel. POWAR is a new surgical technique that can provide an alternative to three-column osteotomy for surgeons performing spinal reconstructions in adults through an open, posterior-only approach. Clin. Anat. 32:348-353, 2019.

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“…Correction of kyphosis at disc level -such as through multilevel posterior interbody fusion (PLIF) 1) , dorsal ventral dorsal correction 2) , and lateral lumbar interbody fusion 3) is indicated for cases in which several intact discs remain. However, for revision cases, the number of intact discs that can be used for kyphosis correction is limited, and pedicle subtraction osteotomy (PSO) that can correct kyphosis at the vertebral body is indicated in most cases.…”

Section: Introductionmentioning

confidence: 99%