scholarly journals Extreme lateral interbody fusion (XLIF) in a consecutive series of 72 patients

2021 ◽  
Author(s):  
Mirza Pojskic ◽  
Benjamin Saβ ◽  
Benjamin Völlger ◽  
Christopher Nimsky ◽  
Barbara Carl
Keyword(s):  
Spinal Canal ◽  
Interbody Fusion ◽  
Spinal Canal Stenosis ◽  
Neurological Deficits ◽  
Consecutive Series ◽  
Radiological Outcome ◽  
Lateral Interbody Fusion ◽  
Canal Stenosis ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody

Extreme lateral interbody fusion (XLIF) has become the standard of minimally invasive lumbar segmental scoliosis treatment. Our objective is to determine the safety and efficacy of XLIF in spinal canal stenosis (SCS) and spondylodiscitis (SD). Patients treated with XLIF in our department between 2012 and 2018 were retrospectively analyzed. Patient records with clinical and radiographical parameters were evaluated. The patient cohort consists of 40 male and 32 female patients with a median age of 66.6 years. Forty-five patients had an SCS and 27 patients SD. The mean follow-up was 23 months. One level XLIF was performed in 49 patients, 2 levels in 15, 3 levels in 7 patients and 4 levels in 1 patient. All but one patient received an additional dorsal stabilization. The pain was present in all patients with a mean Visual Analogue Scale (VAS) score of 8.8 vs. postoperative VAS of 2.8 (p<0.05). Preoperative neurological deficits were found in 44 patients. Only 6 patients had a neurological deterioration, 45 patients improved, and 21 patients remained unchanged. One patient experienced a perioperative complication.  Non-fusion occurred in 8 cases. There were no outcome differences regarding pain and radiological outcome between patients with SCS and SD as well as between patients with one level vs. multilevel surgery. Baseline characteristics and the radiological outcome did not differ between the two groups. Patients with SD had a higher rate of worsening of neurological deficits following surgery, a higher rate of non-fusion, and a longer hospital stay. Patients with spinal canal stenosis SCS had a longer surgery time and more frequent adjacent segment disease.

Radiological and clinical outcomes following extreme lateral interbody fusion

2014 ◽  
Vol 20 (6) ◽  
pp. 623-635 ◽  
Author(s):  
Marjan Alimi ◽  
Christoph P. Hofstetter ◽  
Guang-Ting Cong ◽  
Apostolos John Tsiouris ◽  
Andrew R. James ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Large Population ◽  
Thoracolumbar Spine ◽  
Radiological Outcome ◽  
Lateral Interbody Fusion ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody

Object Extreme lateral interbody fusion (ELIF) is a popular technique for anterior fixation of the thoracolumbar spine. Clinical and radiological outcome studies are required to assess safety and efficacy. The aim of this study was to describe the functional and radiological impact of ELIF in a degenerative disc disease population with a longer follow-up and to assess the durability of this procedure. Methods Demographic and perioperative data for all patients who had undergone ELIF for degenerative lumbar disorders between 2007 and 2011 were collected. Trauma and tumor cases were excluded. For radiological outcome, the preoperative, immediate postoperative, and latest follow-up coronal Cobb angle, lumbar sagittal lordosis, bilateral foraminal heights, and disc heights were measured. Pelvic incidence (PI) and PI–lumbar lordosis (PI-LL) mismatch were assessed in scoliotic patients. Clinical outcome was evaluated using the Oswestry Disability Index (ODI) and visual analog scale (VAS), as well as the Macnab criteria. Results One hundred forty-five vertebral levels were surgically treated in 90 patients. Pedicle screw and rod constructs and lateral plates were used to stabilize fixation in 77% and 13% of cases, respectively. Ten percent of cases involved stand-alone cages. At an average radiological follow-up of 12.6 months, the coronal Cobb angle was 10.6° compared with 23.8° preoperatively (p < 0.0001). Lumbar sagittal lordosis increased by 5.3° postoperatively (p < 0.0001) and by 2.9° at the latest follow-up (p = 0.014). Foraminal height and disc height increased by 4 mm (p < 0.0001) and 3.3 mm (p < 0.0001), respectively, immediately after surgery and remained significantly improved at the last follow-up. Separate evaluation of scoliotic patients showed no statistically significant improvement in PI and PI-LL mismatch either immediately postoperatively or at the latest follow-up. Clinical evaluation at an average follow-up of 17.6 months revealed an improvement in the ODI and the VAS scores for back, buttock, and leg pain by 21.1% and 3.7, 3.6, and 3.7 points, respectively (p < 0.0001). According to the Macnab criteria, 84.8% of patients had an excellent, good, or fair functional outcome. New postoperative thigh numbness and weakness was detected in 4.4% and 2.2% of the patients, respectively, which resolved within the first 3 months after surgery in all but 1 case. Conclusions This study provides what is to the authors' knowledge the most comprehensive set of radiological and clinical outcomes of ELIF in a fairly large population at a midterm follow-up. Extreme lateral interbody fusion showed good clinical outcomes with a low complication rate. The procedure allows for at least midterm clinically effective restoration of disc and foraminal heights. Improvement in coronal deformity and a small but significant increase in sagittal lordosis were observed. Nonetheless, no significant improvement in the PI-LL mismatch was achieved in scoliotic patients.

scholarly journals Stand-Alone Posterior Expandable Cage Technique for Adjacent Segment Degeneration with Lumbar Spinal Canal Stenosis: A Retrospective Case Series

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 237
Author(s):  
Woo-Jin Choi ◽  
Seung-Kook Kim ◽  
Manhal Alaraj ◽  
Hyeun-Sung Kim ◽  
Su-Chan Lee
Keyword(s):  
Sagittal Balance ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Spinal Canal Stenosis ◽  
Adjacent Segment ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal ◽  
Expandable Cages

Background and Objectives: Symptomatic adjacent segment degeneration (ASD) with lumbar spinal canal stenosis (LSCS) is a common complication after spinal intervention, particularly interbody fusion. Stand-alone posterior expandable cages enable interbody fusion with preservation of the previous operation site, and screw-related complications are avoided. Thus, the aim of this study was to investigate the clinicoradiologic outcomes of stand-alone posterior expandable cages for ASD with LSCS. Materials and Methods: Patients with persistent neurologic symptoms and radiologically confirmed ASD with LSCS were evaluated between January 2011 and December 2016. The five-year follow-up data were used to evaluate the long-term outcomes. The radiologic parameters for sagittal balance, pain control (visual analogue scale), disability (Oswestry Disability Index), and early (peri-operative) and late (implant) complications were evaluated. Results: The data of 19 patients with stand-alone posterior expandable cages were evaluated. Local factors, such as intervertebral and foraminal heights, were significantly corrected (p < 0.01 and p < 0.01, respectively), and revision was not reported. The pain level (p < 0.01) and disability rate (p < 0.01) significantly improved, and the early complication rate was low (n = 2, 10.52%). However, lumbar lordosis (p = 0.62) and sagittal balance (p = 0.80) did not significantly improve. Furthermore, the rates of subsidence (n = 4, 21.05%) and retropulsion (n = 3, 15.79%) were high. Conclusions: A stand-alone expandable cage technique should only be considered for older adults and patients with previous extensive fusion. Although this technique is less invasive, improves the local radiologic factors, and yields favorable clinical outcomes with low revision rates, it does not improve the sagittal balance. For more widespread application, the strength of the cage material and high subsidence rates should be improved.

scholarly journals Incisional hernia after extreme lateral interbody fusion on the lumbar spine: A case report

2021 ◽  
Vol 78 ◽  
pp. 130-132
Author(s):  
Masakazu Wakabayashi ◽  
Yurika Miyazaki ◽  
Kana Aoki ◽  
Hayato Yoshida ◽  
Kou Minoshima ◽  
...  
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Incisional Hernia ◽  
Interbody Fusion ◽  
Lateral Interbody Fusion ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody

Endoscope-Assisted Extreme-Lateral Interbody Fusion: Preliminary Experience and Technical Note

2017 ◽  
Vol 103 ◽  
pp. 869-875.e3 ◽  
Author(s):  
Claudio Schonauer ◽  
Martin Nikolaus Stienen ◽  
Oliver Pascal Gautschi ◽  
Karl Schaller ◽  
Enrico Tessitore
Keyword(s):  
Interbody Fusion ◽  
Technical Note ◽  
Lateral Interbody Fusion ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody

Decompression of Lumbar Central Spinal Canal Stenosis Following Minimally Invasive Transforaminal Lumbar Interbody Fusion

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jawad M. Khalifeh ◽  
Lara W. Massie ◽  
Christopher F. Dibble ◽  
Ian G. Dorward ◽  
Mohamed Macki ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Spinal Canal Stenosis ◽  
Lumbar Interbody Fusion ◽  
Canal Stenosis

Comparison of the Safety Outcomes between Anterior Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion

2014 ◽  
Vol 4 (1_suppl) ◽  
pp. s-0034-1376735-s-0034-1376735
Author(s):  
R. Hartl ◽  
F. Christensen ◽  
A. Korge ◽  
K. Lam ◽  
E. Vialle ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Anterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Lateral Interbody Fusion ◽  
Safety Outcomes ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody

Complications in Extreme Lateral Interbody Fusion (XLIF®): A Retrospective Study in Siriraj Hospital

2021 ◽  
Vol 104 (6) ◽  
pp. 1027-1032
Keyword(s):  
Postoperative Complications ◽  
Surgical Complications ◽  
Interbody Fusion ◽  
Early Postoperative Complications ◽  
Lateral Interbody Fusion ◽  
Siriraj Hospital ◽  
Extreme Lateral Interbody Fusion ◽  
Lateral Interbody ◽  
Level Fusion

Background: Extreme Lateral Interbody Fusion (XLIF®) is a well-known transpsoas approach technique that confers advantages including excellent visualization, easy access to the lumbar disc, accommodation for a large anterior graft, restoration of disk height and lumbar alignment, and indirect decompression. However, no study in Thailand has investigated early postoperative complications after spinal fusion with XLIF surgery. Objective: To determine the early postoperative complication rates among Thai patients that underwent spinal fusion with XLIF procedure. Materials and Methods: The present study was a retrospective chart review to evaluate perioperative and early postoperative complications in patients that underwent spinal interbody fusion with XLIF procedure and were followed-up for a minimum of three months at the Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand between 2015 and 2019. Results: One hundred eighteen patients, including 82 females and 36 males, with a mean age of 64.2 years and 165 levels, that were operated upon, were included. Eighty patients (67.8%) underwent one-level fusion, 29 (24.6%) had two-level fusion, and 9 (7.6%) underwent three-level fusion. Immediate postoperative complications occurred in 66 patients (55.9%), consisting of eight (6.7%) with medical complications, 57 (48.3%) with surgical complications, and one (0.8%) with combined medical and surgical complications. Postoperative complications were resolved within three months after surgery in 48 patients. Forty-one patients (34.7%) had postoperative proximal lower limb neuropathy. Only 10 patients (24.4%) still had neuropathy at the 3-month follow-up, but it did not affect their function. Conclusion: Postoperative proximal limb neuropathy, including thigh numbness, pain, or hip flexor weakness, had a high prevalence in the present study despite intraoperative neurophysiologic monitoring; however, most cases resolved by the 3-month follow-up. Patient education about potential nerve irritation complication is recommended, and meticulous preoperative radiographic assessment and careful step-by-step intraoperative surgical approach may reduce the rates of these postoperative complications. Keywords: Extreme lateral interbody fusion; Complications; Neuropathy; Postoperative

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