Lateral Lumbar Interbody Fusion: A Review of the Current Clinical Outcomes of Different Supplemental Fixation Techniques

2016 ◽  
pp. 245-257
Author(s):  
Fred Xavier ◽  
Brendon Walker ◽  
Tucker Callanan ◽  
Samuel Grinberg ◽  
Byung Jo Victor Yoon ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Fixation Techniques ◽  
Supplemental Fixation

The effect of sarcopenia in the clinical outcomes following stand-alone lateral lumbar interbody fusion

2021 ◽  
pp. 1-8
Author(s):  
Hao Li ◽  
Jun Li ◽  
Yaojing Ma ◽  
Fangcai Li ◽  
Zhengkuan Xu ◽  
...  
Keyword(s):  
Back Pain ◽  
Clinical Outcomes ◽  
Gait Speed ◽  
Interbody Fusion ◽  
Univariate Analysis ◽  
Impact Factors ◽  
Lumbar Interbody Fusion ◽  
Improvement Rate ◽  
Single Level ◽  
Lateral Lumbar Interbody Fusion

BACKGROUND: Sarcopenia has been found to affect the postoperative outcomes of lumbar surgery. The effect of sarcopenia on the clinical outcomes in patients who underwent stand-alone lateral lumbar interbody fusion (LLIF) has not yet been examined. OBJECTIVE: To investigate whether sarcopenia affects the Oswestry Disability Index (ODI) and visual analog scale (VAS) score for back pain following single-level stand-alone LLIF. METHODS: Patients who underwent a single level stand-alone LLIF for lumbar diseases were retrospectively investigated. Sarcopenia was defined according to the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. Patients were divided into the sarcopenia (SP) and non-sarcopenia (NSP) group. Univariate analysis was used to compare with regards to demographics and clinical outcomes. Multivariate logistic regression was performed to elucidate factors predicting poor clinically improvement. RESULTS: Sixty-nine patients were enrolled, with 16 and 53 patients in the SP and NSP group respectively. In the SP group, patients were much older (P= 0.002), their body mass index was significantly lower (P< 0.001), the percent of women was higher (P= 0.042), and the skeletal muscle mass index (SMI) (P< 0.001) and gait speed were much lower (P= 0.005). The postoperative ODI scores were much higher and the improvement rate was much lower (both P< 0.001) in the SP group, whereas VAS scores for back pain showed no difference between the two groups. SMI and gait speed had a moderate and weak correlation with the final ODI score, respectively. Low SMI and low gait speed were independently associated with poor clinical outcomes at the final follow-up. CONCLUSIONS: Sarcopenia impacts the final clinical outcomes of stand-alone LLIF for lumbar diseases. Low SMI and low gait speed were negative impact factors for the clinical improvement after stand-alone LLIF.

scholarly journals Biomechanical evaluation of lateral lumbar interbody fusion with secondary augmentation

2016 ◽  
Vol 25 (6) ◽  
pp. 720-726 ◽  
Author(s):  
Marco T. Reis ◽  
Phillip M. Reyes ◽  
Idris Altun ◽  
Anna G. U. S. Newcomb ◽  
Vaneet Singh ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Pedicle Screws ◽  
Axial Rotation ◽  
Lumbar Interbody Fusion ◽  
Lateral Bending ◽  
Lateral Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Flexion Extension ◽  
Supplemental Fixation ◽  
The Stability

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).

Clinical Outcomes of Lateral Lumbar Interbody Fusion Combined with Percutaneous Endoscopic Lumbar Discectomy During the Treatment of Low-grade Spondylolisthesis

2020 ◽  
Author(s):  
Jiaqi Li ◽  
Yapeng Sun ◽  
Wei Zhang ◽  
Fei Zhang ◽  
Lei Guo ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Lumbar Discectomy ◽  
Low Grade ◽  
Lumbar Interbody Fusion ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Lateral Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Endoscopic Lumbar Discectomy

Abstract Background Minimally invasive lateral lumbar interbody fusion (LLIF) in combination with percutaneous endoscopic lumbar discectomy (PELD) can achieve interbody fusion and direct decompression, but their combined use has not been widely reported. In this study, the clinical outcomes of LLIF in combination with PELD in low-grade spondylolisthesis was evaluated, particularly in cases of a requirement for direct decompression. Methods Patients with single-level low-grade spondylolisthesis, undergoing LLIF in combination with PELD were included. The severity of lower back and leg pain was reported using visual analog scale (VAS). The Oswestry disability index (ODI) was used to evaluate functional improvements of patients. A comparison of preoperative and postoperative indicators was performed through repeated measures of analysis of variance. P < 0.05 was considered as a statistically significant difference. Results A total of 48 patients (20 males and 28 females) were included. The intraoperative blood loss was 112.60ml ± 43.69 and the average operation time was 116.35min ± 22.31. VAS and ODI were significantly improved in all stages after operation. The fusion rate at the final follow-up was 93.7%. No injuries occurred to the vessels, nerves and organs during the perioperative period. Conclusions LLIF in combination with PELD achieved adequate decompression and intervertebral fusion, with precise and reliable clinical outcomes. In addition, the procedure was minimally invasive, resulting in small tissue injury and rapid postoperative recovery. Multi-center prospective comparative studies are now needed to further confirm the superiority of this combination.

Intraoperative Radiographs in Single-Level Lateral Lumbar Interbody Fusion Can Predict Radiographic and Clinical Outcomes of Follow-up 2 Years after Surgery

Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jong-myung Jung ◽  
Chun Kee Chung ◽  
Chi Heon Kim ◽  
Seung Heon Yang ◽  
Young San Ko ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Single Level ◽  
Lateral Lumbar Interbody Fusion

Stand-alone minimally invasive lateral lumbar interbody fusion: Multicenter clinical outcomes

2015 ◽  
Vol 22 (4) ◽  
pp. 740-746 ◽  
Author(s):  
Amir Ahmadian ◽  
Konrad Bach ◽  
Bryan Bolinger ◽  
Gregory M. Malham ◽  
David O. Okonkwo ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion

Lateral lumbar interbody fusion in revision surgery for restenosis after posterior decompression

2020 ◽  
Vol 49 (3) ◽  
pp. E11 ◽  
Author(s):  
Yoshifumi Kudo ◽  
Ichiro Okano ◽  
Tomoaki Toyone ◽  
Akira Matsuoka ◽  
Hiroshi Maruyama ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Decompression Surgery ◽  
Complication Rates ◽  
Lumbar Interbody Fusion ◽  
Posterior Decompression ◽  
Lateral Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Dural Tears

OBJECTIVEThe purpose of this study was to compare the clinical results of revision interbody fusion surgery between lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) with propensity score (PS) adjustments and to investigate the efficacy of indirect decompression with LLIF in previously decompressed segments on the basis of radiological assessment.METHODSA retrospective study of patients who underwent revision surgery for recurrence of neurological symptoms after posterior decompression surgery was performed. Postoperative complications and operative factors were evaluated and compared between LLIF and PLIF/TLIF. Moreover, postoperative improvement in cross-sectional areas (CSAs) in the spinal canal and intervertebral foramen was evaluated in LLIF cases.RESULTSA total of 56 patients (21 and 35 cases of LLIF and PLIF/TLIF, respectively) were included. In the univariate analysis, the LLIF group had significantly more endplate injuries (p = 0.03) and neurological deficits (p = 0.042), whereas the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), surgical site infections (SSIs) (p = 0.02), and estimated blood loss (EBL) (p < 0.001). After PS adjustments, the LLIF group still showed significantly more endplate injuries (p = 0.03), and the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), EBL (p < 0.001), and operating time (p = 0.04). The PLIF/TLIF group showed a trend toward a higher incidence of SSI (p = 0.10). There was no statistically significant difference regarding improvement in the Japanese Orthopaedic Association scores between the 2 surgical procedures (p = 0.77). The CSAs in the spinal canal and foramen were both significantly improved (p < 0.001).CONCLUSIONSLLIF is a safe, effective, and less invasive procedure with acceptable complication rates for revision surgery for previously decompressed segments. Therefore, LLIF can be an alternative to PLIF/TLIF for restenosis after posterior decompression surgery.

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