Using an Extreme Lateral Interbody Fusion (XLIF) in Revising Failed Transforaminal Lumbar Interbody Fusion (TLIF) With Exchange of Cage

Al-Rabiah, Anwar M; Alghafli, Zahraa I; Almazrua, Ibrahim

doi:10.7759/cureus.14123

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…There has been a rapid increase in the popularity of minimally invasive techniques, XLIF being one of them [15]. More than 20% of spinal fusions being performed in the United States utilize the XLIF or DLIF approach [16,17], while 14% of spinal fusions being performed in the United Kingdom utilize the XLIF or DLIF approach [18].…”

Section: Discussionmentioning

confidence: 99%

Management of Massive Flank Hernia After Lateral Lumbar Fusion: Preoperative Botulinum Toxin Injections and Open Repair – A Case Report

Cifuentes,

Khan,

Castro Hernandez

et al. 2024

Am J Case Rep

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Unusual or unexpected effect of treatment Background:Incisional flank hernias represent a complication after lateral lumbar spine surgery. Given the increasing rate of lateral lumbar interbody fusions, the rate of incisional flank hernias will increase. Since there are no reports of open massive flank hernia repair utilizing preoperative botulinum injections, we sought to publish this technique to provide surgeons with an innovative method for preoperatively treating patients with massive flank hernias. Case Report:A 75-year-old man with a history of coronary artery disease, chronic kidney disease, and abdominal hernia repair presented for evaluation of left lateral abdominal and left lower back bulging for 5 months. The symptoms began after an L2-L4 lateral lumbar spinal fusion. Physical examination revealed a left posterior lateral flank bulge. Computed tomography (CT) showed a fat-containing left posterolateral abdominal hernia. The patient was scheduled for CT-guided lateral abdominal wall botulinum injections, followed by open flank hernia repair. He tolerated the surgery well, was admitted for pain control, and discharged on day 2. Repeat imaging with CT at 3 months showed no evidence of patient's prior hernia defect. Conclusions:Open flank hernia repair, in conjunction with preoperative botulinum toxin injections, allows for optimal visualization and re-approximation of the myofascial components of flank hernia defects. Failure to achieve adequate myofascial and skin closure, along with mesh reinforcement, in open flank hernia repair can result in various surgical site complications, including incisional flank hernia recurrence. We recommend further investigation on the benefits of botulinum injections as an adjunct in management of massive flank hernias.

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Section: Discussionmentioning

confidence: 99%

Management of Massive Flank Hernia After Lateral Lumbar Fusion: Preoperative Botulinum Toxin Injections and Open Repair – A Case Report

Cifuentes,

Khan,

Castro Hernandez

et al. 2024

Am J Case Rep

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“…Theoretically, lumbar spinal fusion surgeries involved the risk of fusion cage retropulsion. The endoscopic surgery can allow minimal blood loss and focused neural decompression to reduce the complication 8–10 . However, it should be noted that for patients with neurological symptoms resulting from poor positioning of the cage and interbody fusion, in most cases there are few reports concerning the technique of its revision in the literature.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Revision for Long‐Term Symptomatic Cage Retropulsion after TLIF: The Clinical Presentation in a Single Center

Zhu

Jiang

et al. 2023

Orthopaedic Surgery

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Background Cage retropulsion after transforaminal lumbar interbody fusion (TLIF) is a common complication that is more frequently detected in the early postoperative period. Revision in the early stages is relatively less difficult in symptomatic cases. However, cage retropulsion is quite rare for patients with intervertebral osseous fusion in the long term after TLIF, and there are no relevant reports related to the revision plan. Case presentation Here, we report a case of a patient who underwent L4‐S1 TLIF at another hospital 4 years ago, accompanied by recurrent pain and discomfort of the left lower limb after the operation. Due to recent condition aggravation, it was considered to be caused by compression of the nerve root due to cage retropulsion. Nerve root sealing and endoscopy surgery were performed on the operative segment. It was found that cage retropulsion at the L4/5 level was a suspicious focus according to careful analysis of the clinical manifestations of the patient. Selective block of the nerve root on the level resulted in relief of the patient's original symptoms. After the posterior edge of the cage was exposed under the endoscope through an intervertebral foramen approach, the posterior edge of the cage protruding into the spinal canal was removed by high‐speed burr grinding, working casing reduction and other methods. Postoperative symptoms of pain in the low back and lower limb were relieved completely. Conclusions It is feasible to use the power system to remove the retrograde cage under the endoscope through the intervertebral foramen approach for the revision of symptomatic polyether ether ketone (PEEK) cage retropulsion in the long term after TLIF.

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“…[ 2 ] Lateral, oblique, or anterior approaches have been suggested for removal of extruded cages. [ 3 ] In our literature review, only one report describing a transdural approach for this pathology was found. [ 4 ] We demonstrate the efficacy of this approach when operative anatomy complicates removal through other approaches.…”

Section: Introductionmentioning

confidence: 99%

Transdural retrieval of retropulsed transforaminal lumbar interbody fusion cages

Lefever,

Leveque,

Hanks

et al. 2024

Journal of Craniovertebral Junction and Spine

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Transforaminal lumbar interbody fusions (TLIFs) are performed for various lumbar spine pathologies. Posterior migration of an interbody cage is a complication that may result in neurologic injury and require reoperation. Sparse information exists regarding the safety and efficacy of a transdural approach for cage retrieval. We describe a surgical technique, in which centrally retropulsed cages were safely retrieved transdurally. A patient with prior L3-S1 posterior lumbar fusion and L4-S1 TLIFs presented with radiculopathy and weakness in dorsiflexion. Imaging revealed posterior central migration of TLIF cages causing compression of the traversing L5 nerve root. Cages were removed transdurally; the correction was performed with an all-posterior T10-pelvis fusion. Aside from temporary weakness in right-sided dorsiflexion, the patient experienced complete resolution in their radiculopathy and strength returned to its presurgical state by 3 months. The transdural approach for interbody removal can be safely performed and should be a tool in the spine surgeon’s armamentarium.

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Using an Extreme Lateral Interbody Fusion (XLIF) in Revising Failed Transforaminal Lumbar Interbody Fusion (TLIF) With Exchange of Cage

Abstract: Al-Rabiah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 6 publications

References 14 publications

Management of Massive Flank Hernia After Lateral Lumbar Fusion: Preoperative Botulinum Toxin Injections and Open Repair – A Case Report

Management of Massive Flank Hernia After Lateral Lumbar Fusion: Preoperative Botulinum Toxin Injections and Open Repair – A Case Report

Endoscopic Revision for Long‐Term Symptomatic Cage Retropulsion after TLIF: The Clinical Presentation in a Single Center

Transdural retrieval of retropulsed transforaminal lumbar interbody fusion cages

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