Extreme lateral lumbar interbody fusion. Surgical technique, outcomes and complications after a minimum of one year follow-up

Rev Esp Cir Ortop Traumatol. 2017 Jan-Feb;61(1):8-18. doi: 10.1016/j.recot.2016.09.001. Epub 2016 Dec 3.
[Article in English, Spanish]

Abstract

«Minimally invasive» techniques have been recently been developed in order to achieve good clinical results with a low incidence of complications. The extralateral interbody fusion or direct transpsoas is a minimally invasive anterior arthrodesis. A total of 97 patients with 138 segments received surgery between May 2012 and May 2015. The follow-up was from 12-44 months. The mean age was 68 years (41-86). The most common cause of intervention was the adjacent segment (30%), deformity (22%), and lumbar disc disease (21%). The interbody cage was implanted as: Single (stand-alone) in 33%, and additional fixation was used in the others: Screws, percutaneous unilateral (11%), bilateral (27%), or with a lateral plate (62%). The mean stay was 3.2 days (2-6). The score on a lumbar visual analogue scale decreased from 9 to 4.1, and dropped to 3 after one year. The improvement in disc height was from 8.4mm to 13.8mm, and a larger increase in the foramen diameter from 10.5 to 13.1mm, which were statistically significant. The early major complications recorded were, three motor femoral nerve injuries and retroperitoneal haematoma (4%), and the early minor were: two fractures (2%). As major late complications there was an abdominal hernia, a mobilization of 10mm and three radiculopathy (5%), and as minor late, three fracture, two mobilisations greater than 10mm, four mobilisations of less than 10mm, and one mobilisation of a screw plate (10%). The extralateral interbody fusion technique is a safe and reliable when performing a lumbar fusion by an alternative minimally invasive route.

Keywords: Artrodesis intersomática extralateral; Complicaciones; Complications; Extra-lateral body fusion; Outcomes; Resultados.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Plates
  • Bone Screws
  • Female
  • Follow-Up Studies
  • Humans
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / instrumentation
  • Minimally Invasive Surgical Procedures / methods*
  • Outcome Assessment, Health Care
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Spinal Fusion / instrumentation
  • Spinal Fusion / methods*