Lateral Lumbar Interbody Fusion for the Correction of Spondylolisthesis and Adult Degenerative Scoliosis in High-Risk Patients: Early Results and Complications

Waddell, Bradford S.; Briski, David C.; Zavatsky, Joseph M.

doi:10.1055/s-0035-1554259

Cited by 10 publications

(11 citation statements)

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“…Of the 17 retrospective studies, 5 were graded as level of evidence II [13][14][15][16][17] and 12 graded as level of evidence III. [18][19][20][21][22][23][24][25][26][27][28][29] Of the 7 prospective studies, 3 were graded as level of evidence I, [30][31][32] 3 graded as level of evidence II, 23,33,34 and one graded as level of evidence III. 35 Intraoperative neuromonitoring was used in all studies with the exception of two, 14,36 where its use was at the surgeon's discretion.…”

Section: Study Selectionmentioning

confidence: 99%

Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

2015

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BackgroundLateral transpsoas interbody fusion (LTIF) is a minimally invasive technique for achieving lumbar spinal fusion. While it has many advantages over open techniques it carries with it a distinct set of risks, most commonly postoperative ipsilateral thigh pain, weakness and sensory disturbances. It is vital for both the surgeon and patient to understand the risks for and outcomes of injury associated with this procedure. We conducted a systematic review of the literature to evaluate the incidence, risks, and long-term clinical outcomes of post-operative thigh symptoms in patients treated with LTIF.

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Section: Study Selectionmentioning

confidence: 99%

Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

2015

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“…32 Several clinical studies involving LLIF have been reported in the medical literature, including more than 1700 patients with good outcomes and low complication rates. 1,10,11,20,22,27,35,36,41,[43][44][45] To date, biomechanical studies evaluating the performance of LLIF have generally demonstrated improved stability with LLIF compared with other lumbar interbody fusion procedures, improved biomechanical performance with an interbody implant placed using the LLIF approach without supplemental fixation compared with the intact condition, and further significant improvements in LLIF construct stability following the application of supplemental fixation. 2,3,5,12,13,21,31,32 In addition to investigating the biomechanical effects of an interbody implant and an interbody implant supplemented with posterior screw instrumentation placed using the LLIF approach, the current study is one of very few to include both IP and LP supplemental fixation.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of lateral lumbar interbody fusion with secondary augmentation

Reis

Reyes²,

Bse

et al. 2016

SPI

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OBJECTIVE Lateral lumbar interbody fusion (LLIF) has emerged as a popular method for lumbar fusion. In this study the authors aimed to quantify the biomechanical stability of an interbody implant inserted using the LLIF approach with and without various supplemental fixation methods, including an interspinous plate (IP). METHODS Seven human cadaveric L2–5 specimens were tested intact and in 6 instrumented conditions. The interbody implant was intended to be used with supplemental fixation. In this study, however, the interbody was also tested without supplemental fixation for a relative comparison of these conditions. The instrumented conditions were as follows: 1) interbody implant without supplemental fixation (LLIF construct); and interbody implant with supplemental fixation performed using 2) unilateral pedicle screws (UPS) and rod (LLIF + UPS construct); 3) bilateral pedicle screws (BPS) and rods (LLIF + BPS construct); 4) lateral screws and lateral plate (LP) (LLIF + LP construct); 5) interbody LP and IP (LLIF + LP + IP construct); and 6) IP (LLIF + IP construct). Nondestructive, nonconstraining torque (7.5 Nm maximum) induced flexion, extension, lateral bending, and axial rotation, whereas 3D specimen range of motion (ROM) was determined optoelectronically. RESULTS The LLIF construct reduced ROM by 67% in flexion, 52% in extension, 51% in lateral bending, and 44% in axial rotation relative to intact specimens (p < 0.001). Adding BPS to the LLIF construct caused ROM to decrease by 91% in flexion, 82% in extension and lateral bending, and 74% in axial rotation compared with intact specimens (p < 0.001), providing the greatest stability among the constructs. Adding UPS to the LLIF construct imparted approximately one-half the stability provided by LLIF + BPS constructs, demonstrating significantly smaller ROM than the LLIF construct in all directions (flexion, p = 0.037; extension, p < 0.001; lateral bending, p = 0.012) except axial rotation (p = 0.07). Compared with the LLIF construct, the LLIF + LP had a significant reduction in lateral bending (p = 0.012), a moderate reduction in axial rotation (p = 0.18), and almost no benefit to stability in flexion-extension (p = 0.86). The LLIF + LP + IP construct provided stability comparable to that of the LLIF + BPS. The LLIF + IP construct provided a significant decrease in ROM compared with that of the LLIF construct alone in flexion and extension (p = 0.002), but not in lateral bending (p = 0.80) and axial rotation (p = 0.24). No significant difference was seen in flexion, extension, or axial rotation between LLIF + BPS and LLIF + IP constructs. CONCLUSIONS The LLIF construct that was tested significantly decreased ROM in all directions of loading, which indicated a measure of inherent stability. The LP significantly improved the stability of the LLIF construct in lateral bending only. Adding an IP device to the LLIF construct significantly improves stability in sagittal plane rotation. The LLIF + LP + IP construct demonstrated stability comparable to that of the gold standard 360° fixation (LLIF + BPS).

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“…It has been shown that the sagittal malalignment is the most common factor responsible for pain and disability in this population [26,27].…”

Section: Clinical Issuesmentioning

confidence: 96%

Role of Minimally Invasive Spine Surgery in Adults with Degenerative Lumbar Scoliosis: A Narrative Review

Tannoury

Haddadi

Kempegowda

et al. 2017

IrJNS

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Background and Aim: Degenerative lumbar scoliosis is a spinal deformity resulting from advanced disc degeneration and facet arthropathy. Given the inconclusive available literature and lack of high-quality data supporting the role of minimally invasive surgical management of degenerative lumbar scoliosis, this review intends to highlight and compare the various viable minimally invasive surgical methods for adult degenerative deformity correction. Methods and Materials/Patients:Online databases search including Medline, PubMed and Ovid was preformed using the keywords: adult, degenerative, lumbar scoliosis, etiology, clinical issues, diagnostic imaging, spinopelvic alignment, non-operative and surgical treatment options, minimally invasive, interbody fusion, and percutaneous pedicle screw fixation. Eighty-three studies, published after 2000, on degenerative lumbar scoliosis epidemiology, classification and management were identified and reviewed.Results: Minimally invasive surgical techniques available for interbody fusion include posterior lumbar interbody fusion, transformational lumbar interbody fusion, oblique lumbar interbody fusion, anterior lumbar interbody fusion, and extreme lateral interbody fusion. Each surgical option warrants technical considerations, indication, complications awareness, and functional and radiological outcomes assessment. Sound patients' selection is key for improved outcomes, and therefore the following factors should be well examined prior to surgical intervention: the patient's medical condition and underlying morbidities, the extent of the involved disc spaces, imaging characteristics, and surgeon skills. Conclusion:The superiority of one surgical technique over the others, was not proven due to lack of strong and supportive data. However, a comprehensive review of indications, benefits, and disadvantages of the minimally invasive surgical procedures is presented. There is an interest in minimally invasive surgery of the spine owing to lower complication rates and morbidity, with limited soft tissue disturbance, decreased blood loss, improved cosmesis, shorter hospital stay, earlier return to work, and therefore decreased general health care costs.

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Lateral Lumbar Interbody Fusion for the Correction of Spondylolisthesis and Adult Degenerative Scoliosis in High-Risk Patients: Early Results and Complications

Cited by 10 publications

References 0 publications

Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

Biomechanical evaluation of lateral lumbar interbody fusion with secondary augmentation

Role of Minimally Invasive Spine Surgery in Adults with Degenerative Lumbar Scoliosis: A Narrative Review

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