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26.10.2017 | Treatment of Lumbar Degenerative Pathology (HJ Kim and G Mundis, section editors) | Ausgabe 4/2017

Current Reviews in Musculoskeletal Medicine 4/2017

Interbody Fusion Techniques in the Surgical Management of Degenerative Lumbar Spondylolisthesis

Zeitschrift:
Current Reviews in Musculoskeletal Medicine > Ausgabe 4/2017
Autoren:
Peter B. Derman, Todd J. Albert
Wichtige Hinweise
This article is part of the Topical Collection on Treatment of Lumbar Degenerative Pathology

Abstract

Purpose of Review

The various lumbar interbody fusion (IBF) techniques and the evidence for their use in the treatment of degenerative lumbar spondylolisthesis (DLS) are described in this review.

Recent Findings

The existing evidence is mixed regarding the indications for and utility of IBF in DLS, but its use in the setting of pre-operative instability is most strongly supported. Anterior (ALIF), lateral (LLIF), posterior (PLIF), transforaminal (TLIF), and axial (AxiaLIF) lumbar IBF approaches have been described. While the current data are limited, TLIF may be a better option than PLIF in DLS due the increased operative morbidity and peri-operative complications observed with the latter. LLIF also appears superior to PLIF in light of improved radiologic outcomes, fewer intra-operative complications, and potentially greater improvements in disability. The data comparing LLIF to TLIF are less conclusive. No studies specifically comparing ALIF or AxiaLIF to other IBF techniques could be identified.

Summary

Instability may be the strongest indication for IBF in DLS. When IBF is employed, the authors’ preferred technique is TLIF with posterior segmental spinal instrumentation. Further research is needed.

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