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Erschienen in: European Spine Journal 6/2014

01.10.2014 | Original Article

Extreme lateral approach to the spine in degenerative and post traumatic lumbar diseases: selection process, results and complications

verfasst von: Matteo Formica, Pedro Berjano, Luca Cavagnaro, Andrea Zanirato, Andrea Piazzolla, Carlo Formica

Erschienen in: European Spine Journal | Sonderheft 6/2014

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Abstract

Purpose of the study

The aim of this study is to describe clinical and radiological outcomes as well as accompanying complications in a series of consecutive lateral transpsoas approaches (XLIF).

Materials and methods

A retrospective study of 39 patients treated for degenerative and post-traumatic lumbar diseases was carried out. Functional status, leg and back pain and radiological outcomes were evaluated pre and post-operatively using the Oswestry disability index score (ODI) visual analog scales (VAS) and X-ray studies.

Results

Mean follow-up was 16 months (range 12–24 months). Mean improvement in back and leg pain on VAS was 6.08 (p < 0.01) and 2.77 (p < 0.01), respectively. Mean improvement in the ODI score was 38 (p < 0.01). Increases in lumbar lordosis (32.8°–39.2°, p < 0.05) and disc height (3.6–4.8 mm, p < 0.05) were noted in the post-operative. Mild, transient strength deficit of the quadriceps muscle was also noted in ten cases with complete regression.

Conclusions

XLIF proved to be a safe, effective, minimally invasive technique that allows valid arthrodesis to be carried out. Patients achieved positive clinical outcomes and satisfactory fusion rates, with sustained restoration of lordosis, spinal alignment and disc height.
Literatur
1.
Zurück zum Zitat Pimenta L (2001) Lateral endoscopic transpsoas retroperitoneal approach for lumbar spine surgery. Paper presented at the VIII Brazilian Pine Society Meeting, Belo Horizonte, Minas Gerais, Brazil, May 2001 Pimenta L (2001) Lateral endoscopic transpsoas retroperitoneal approach for lumbar spine surgery. Paper presented at the VIII Brazilian Pine Society Meeting, Belo Horizonte, Minas Gerais, Brazil, May 2001
2.
Zurück zum Zitat Ozgur BM, Aryan HE, Pimenta L, Taylor WR (2006) Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine 6:435–443CrossRef Ozgur BM, Aryan HE, Pimenta L, Taylor WR (2006) Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine 6:435–443CrossRef
3.
Zurück zum Zitat Billinghurst J, Akbarnia BA (2009) Extreme lateral interbody fusion–XLIF. Curr Orthop Pract 20(3):238–251CrossRef Billinghurst J, Akbarnia BA (2009) Extreme lateral interbody fusion–XLIF. Curr Orthop Pract 20(3):238–251CrossRef
4.
Zurück zum Zitat Sasso RC, Best NM, Mummaneni PV et al (2005) Analysis of operative complications in a series of 471 anterior lumbar interbody fusion procedures. Spine 30:670–674PubMedCrossRef Sasso RC, Best NM, Mummaneni PV et al (2005) Analysis of operative complications in a series of 471 anterior lumbar interbody fusion procedures. Spine 30:670–674PubMedCrossRef
5.
Zurück zum Zitat Brau SA, Delamarter RB, Schiffman ML, Williams LA, Watkins RG (2004) Vascular injury during anterior lumbar surgery. Spine J 4:409–412PubMedCrossRef Brau SA, Delamarter RB, Schiffman ML, Williams LA, Watkins RG (2004) Vascular injury during anterior lumbar surgery. Spine J 4:409–412PubMedCrossRef
6.
Zurück zum Zitat Tiusanen H, Seitsalo S, Osterman K et al (1995) Retrograde ejaculation after anterior interbody lumbar fusion. Euro Spine J 4:339–342CrossRef Tiusanen H, Seitsalo S, Osterman K et al (1995) Retrograde ejaculation after anterior interbody lumbar fusion. Euro Spine J 4:339–342CrossRef
7.
Zurück zum Zitat Isiklar ZU, Lindsey RW, Coburn M (1996) Ureteral injury after anterior lumbar interbody fusion. A case report. Spine 21:2379–2382PubMedCrossRef Isiklar ZU, Lindsey RW, Coburn M (1996) Ureteral injury after anterior lumbar interbody fusion. A case report. Spine 21:2379–2382PubMedCrossRef
8.
Zurück zum Zitat Rajaraman V, Vingan R, Roth P, Heary RF, Conklin L, Jacobs GB (1999) Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg 91(1 Suppl):60–64PubMed Rajaraman V, Vingan R, Roth P, Heary RF, Conklin L, Jacobs GB (1999) Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg 91(1 Suppl):60–64PubMed
9.
Zurück zum Zitat Sofianos DA, Briseno MR, Abrams J, Patel AA (2012) Complications of the lateral transpsoas approach for lumbar interbody arthrodesis. Clin Orthop Relat Res 470:1621–1632PubMedCrossRefPubMedCentral Sofianos DA, Briseno MR, Abrams J, Patel AA (2012) Complications of the lateral transpsoas approach for lumbar interbody arthrodesis. Clin Orthop Relat Res 470:1621–1632PubMedCrossRefPubMedCentral
10.
Zurück zum Zitat Cho KJ, Suk SI, Park SR, Kim JH, Kim SS, Choi WK, Lee KY, Lee SR (2007) Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis. Spine (Phila Pa 1976) 32:2232–2237CrossRef Cho KJ, Suk SI, Park SR, Kim JH, Kim SS, Choi WK, Lee KY, Lee SR (2007) Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis. Spine (Phila Pa 1976) 32:2232–2237CrossRef
11.
Zurück zum Zitat Scaduto AA, Gamradt SC, Yu WD, Huang J, Delamarter RB, Wang JC (2003) Perioperative complications of threaded cylindrical lumbar interbody fusion devices: anterior versus posterior approach. J Spinal Disord Tech 16:502–507PubMedCrossRef Scaduto AA, Gamradt SC, Yu WD, Huang J, Delamarter RB, Wang JC (2003) Perioperative complications of threaded cylindrical lumbar interbody fusion devices: anterior versus posterior approach. J Spinal Disord Tech 16:502–507PubMedCrossRef
12.
Zurück zum Zitat DiPaola CP, Molinari RW (2008) Posterior lumbar interbody fusion. J Am Acad Orthop Surg 16:130–139PubMed DiPaola CP, Molinari RW (2008) Posterior lumbar interbody fusion. J Am Acad Orthop Surg 16:130–139PubMed
14.
Zurück zum Zitat Berjano P, Lamartina C (2011) Minimally invasive lateral transpsoas approach with advanced neurophysiologic monitoring for lumbar interbody fusion. Eur Spine J 20:1584–1586PubMedCrossRef Berjano P, Lamartina C (2011) Minimally invasive lateral transpsoas approach with advanced neurophysiologic monitoring for lumbar interbody fusion. Eur Spine J 20:1584–1586PubMedCrossRef
15.
Zurück zum Zitat Berjano P, Lamartina C (2013) Far lateral approaches (XLIF) in adult scoliosis. Eur Spine J 22(Suppl 2):S242–S253PubMedCrossRef Berjano P, Lamartina C (2013) Far lateral approaches (XLIF) in adult scoliosis. Eur Spine J 22(Suppl 2):S242–S253PubMedCrossRef
16.
Zurück zum Zitat Tormenti MJ, Maserati MB, Bonfield CM, Okonkwo DO, Kanter AS (2010) Complications and radiographic correction in adult scoliosis following combined transpsoas extreme lateral interbody fusion and posterior pedicle screw instrumentation. Neurosurg Focus 28:E7PubMedCrossRef Tormenti MJ, Maserati MB, Bonfield CM, Okonkwo DO, Kanter AS (2010) Complications and radiographic correction in adult scoliosis following combined transpsoas extreme lateral interbody fusion and posterior pedicle screw instrumentation. Neurosurg Focus 28:E7PubMedCrossRef
17.
Zurück zum Zitat Pimenta L, Oliveira L, Schaffa T, Coutinho E, Marchi L (2011) Lumbar total disc replacement from an extreme lateral approach: clinical experience with a minimum of 2 years’ follow-up. J Neurosurg Spine 14:38–45PubMedCrossRef Pimenta L, Oliveira L, Schaffa T, Coutinho E, Marchi L (2011) Lumbar total disc replacement from an extreme lateral approach: clinical experience with a minimum of 2 years’ follow-up. J Neurosurg Spine 14:38–45PubMedCrossRef
18.
Zurück zum Zitat Malham GM, Ellis NJ, Parker RM, Seex KA (2012) Clinical outcome and fusion rates after the first 30 extreme lateral interbody fusions. Sci World J 2012:246989. doi:10.1100/2012/246989 CrossRef Malham GM, Ellis NJ, Parker RM, Seex KA (2012) Clinical outcome and fusion rates after the first 30 extreme lateral interbody fusions. Sci World J 2012:246989. doi:10.​1100/​2012/​246989 CrossRef
19.
Zurück zum Zitat Meredith DS, Kepler CK, Huamg RC, Hegde VV (2013) Extreme lateral interbody fusion (XLIF) in the thoracic and thoracolumbar spine: technical report and early outcomes. HSSJ 9:25–31CrossRef Meredith DS, Kepler CK, Huamg RC, Hegde VV (2013) Extreme lateral interbody fusion (XLIF) in the thoracic and thoracolumbar spine: technical report and early outcomes. HSSJ 9:25–31CrossRef
20.
Zurück zum Zitat Rodgers WB, Cox CS, Gerber EJ (2007) Experience and early results with a minimally invasive technique for anterior column support through extreme lateral interbody fusion (XLIF). US Musculoskel Rev 2:28–32 Rodgers WB, Cox CS, Gerber EJ (2007) Experience and early results with a minimally invasive technique for anterior column support through extreme lateral interbody fusion (XLIF). US Musculoskel Rev 2:28–32
21.
Zurück zum Zitat Rodgers WB, Cox CS, Gerber EJ (2010) Early complications of extreme lateral interbody fusion in the obese. J Spinal Disord Tech 23:393–397PubMedCrossRef Rodgers WB, Cox CS, Gerber EJ (2010) Early complications of extreme lateral interbody fusion in the obese. J Spinal Disord Tech 23:393–397PubMedCrossRef
22.
Zurück zum Zitat Rodgers WB, Gerber EJ, Patterson J (2011) Intraoperative and early postoperative complications in extreme lateral interbody fusion: an analysis of 600 cases. Spine (Phila Pa 1976) 36:26–32CrossRef Rodgers WB, Gerber EJ, Patterson J (2011) Intraoperative and early postoperative complications in extreme lateral interbody fusion: an analysis of 600 cases. Spine (Phila Pa 1976) 36:26–32CrossRef
23.
Zurück zum Zitat Youssef JA, McAfee PC, Patty CA et al (2010) Minimally invasive surgery: lateral approach interbody fusion: results and review. Spine (Phila Pa 1976) 35:S302–S311CrossRef Youssef JA, McAfee PC, Patty CA et al (2010) Minimally invasive surgery: lateral approach interbody fusion: results and review. Spine (Phila Pa 1976) 35:S302–S311CrossRef
24.
Zurück zum Zitat Uribe JS, Dakwar E, Le TV, Christian G, Serrano S, Smith WD (2010) Minimally invasive surgery treatment for thoracic spine tumor removal: a mini-open, lateral approach. Spine (Phila Pa1976) 35:S347–S354CrossRef Uribe JS, Dakwar E, Le TV, Christian G, Serrano S, Smith WD (2010) Minimally invasive surgery treatment for thoracic spine tumor removal: a mini-open, lateral approach. Spine (Phila Pa1976) 35:S347–S354CrossRef
25.
Zurück zum Zitat Smith WD, Dakwar E, Le TV, Christian G, Serrano S, Uribe JS (2010) Minimally invasive surgery for traumatic spinal pathologies: a mini-open, lateral approach in the thoracic and lumbar spine. Spine (Phila Pa 1976) 35:S338–S346CrossRef Smith WD, Dakwar E, Le TV, Christian G, Serrano S, Uribe JS (2010) Minimally invasive surgery for traumatic spinal pathologies: a mini-open, lateral approach in the thoracic and lumbar spine. Spine (Phila Pa 1976) 35:S338–S346CrossRef
26.
Zurück zum Zitat Tohmeh AG, Rodgers WB, Peterson MD (2011) Dynamically evoked, discrete-threshold electromyography in the extreme lateral interbody fusion approach. J Neurosurg Spine 14:31–37PubMedCrossRef Tohmeh AG, Rodgers WB, Peterson MD (2011) Dynamically evoked, discrete-threshold electromyography in the extreme lateral interbody fusion approach. J Neurosurg Spine 14:31–37PubMedCrossRef
27.
Zurück zum Zitat Uribe JS, Vale FL, Dakwar E (2010) Electromyographic monitoring and its anatomical implications in minimally invasive spine surgery. Spine (Phila Pa 1976) 35:S368–S374CrossRef Uribe JS, Vale FL, Dakwar E (2010) Electromyographic monitoring and its anatomical implications in minimally invasive spine surgery. Spine (Phila Pa 1976) 35:S368–S374CrossRef
28.
Zurück zum Zitat Uribe JS, Arredondo N, Dakwar E, Vale FL (2010) Defining the safe working zones using the minimally invasive lateral retroperitoneal transpsoas approach: an anatomical study. J Neurosurg Spine 13:260–266PubMedCrossRef Uribe JS, Arredondo N, Dakwar E, Vale FL (2010) Defining the safe working zones using the minimally invasive lateral retroperitoneal transpsoas approach: an anatomical study. J Neurosurg Spine 13:260–266PubMedCrossRef
29.
Zurück zum Zitat Ebraheim NA, Xu R, Huntoon M et al (1997) Location of the extraforaminal lumbar nerve roots. An anatomic study. Clin Orthop 340:230–235PubMedCrossRef Ebraheim NA, Xu R, Huntoon M et al (1997) Location of the extraforaminal lumbar nerve roots. An anatomic study. Clin Orthop 340:230–235PubMedCrossRef
30.
Zurück zum Zitat Gu Y, Ebraheim NA, Xu R et al (2001) Anatomic considerations of the posterolateral lumbar disk region. Orthopedics 24:56–58PubMed Gu Y, Ebraheim NA, Xu R et al (2001) Anatomic considerations of the posterolateral lumbar disk region. Orthopedics 24:56–58PubMed
31.
Zurück zum Zitat Cummock MD, Vanni S, Levi AD et al (2011) An analysis of postoperative thigh symptoms after minimally invasive transpsoas lumbar interbody fusion. J Neurosurg Spine 15:11–18PubMedCrossRef Cummock MD, Vanni S, Levi AD et al (2011) An analysis of postoperative thigh symptoms after minimally invasive transpsoas lumbar interbody fusion. J Neurosurg Spine 15:11–18PubMedCrossRef
Metadaten
Titel
Extreme lateral approach to the spine in degenerative and post traumatic lumbar diseases: selection process, results and complications
verfasst von
Matteo Formica
Pedro Berjano
Luca Cavagnaro
Andrea Zanirato
Andrea Piazzolla
Carlo Formica
Publikationsdatum
01.10.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe Sonderheft 6/2014
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3545-y

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