Safety Profile, Surgical Technique, and Early Clinical Results for Simultaneous Lateral Lumbar Interbody Fusion and Anterior Lumbar Interbody Fusion in a Lateral Position. Academic Article uri icon

Overview

abstract

  • STUDY DESIGN: Description of surgical technique and retrospective review. OBJECTIVE: To describe a novel surgical technique for multilevel lumbar fusion and describe early clinical results. SUMMARY OF BACKGROUND DATA: Patients with multilevel lumbar spinal stenosis and adult degenerative scoliosis often require multilevel interbody placement to achieve indirect decompression and lordosis. We describe a case series of patients treated with simultaneous lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF) at L5-S1. METHODS: We retrospectively reviewed a consecutive series of patients treated for multilevel lumbar spinal stenosis with simultaneous ALIF and LLIF with at least 3-month follow-up. All patients received supplemental percutaneous bilateral pedicle screw placement as well. We measured on preoperative radiographs their lumbar lordosis, pelvic incidence, and L5-S1 lordosis. Intraoperative factors such as operative time, estimated blood loss, fluids provided, number of levels fused, and whether a trainee was present during the procedure were all recorded. RESULTS: There were 15 patients included within our case series (69.5, 4 F). There were no reported intraoperative vascular or neurological complications in 15 cases. The operative time for the cases ranged from 2.7 to 8.4 hours (average=5.2±1.9 h). The average lordosis gained at L5-S1 was 8.6±3.0 degrees and the average lumbar lordosis gained was 14.7±6.4 degrees. The average PI-LL mismatch went from 22.4±13.3 degrees preoperative to 7.8±10.2 degrees postoperative. One patient had a postoperative complication of a sacral fracture requiring placement of a pelvic screw for a L2-pelvis fusion. There were 8 patients with 4+ levels of fusion. For this cohort of patients, the average lumbar lordosis gained was 16.0±7.5 degrees and the average PI-LL mismatch went from 24.7±16.3 degrees preoperative to 8.8±12.9 degrees postoperative. For the patients with 4+ levels of fusion, the average operative time was 5.9±1.8 hours. CONCLUSIONS: We have described our early positive results with simultaneous LLIF/ALIF surgery for treatment of lumbar degenerative conditions.

publication date

  • March 1, 2021

Research

keywords

  • Lordosis
  • Spinal Fusion

Identity

Scopus Document Identifier

  • 85101756104

Digital Object Identifier (DOI)

  • 10.1097/BSD.0000000000001044

PubMed ID

  • 33633065

Additional Document Info

volume

  • 34

issue

  • 2