Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Reviews in Musculoskeletal Medicine
Erschienen in: Current Reviews in Musculoskeletal Medicine 4/2017

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

Interbody Fusion Techniques in the Surgical Management of Degenerative Lumbar Spondylolisthesis

verfasst von: Peter B. Derman, Todd J. Albert

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Jacobsen S, Sonne-Holm S, Rovsing H, Monrad H, Gebuhr P. Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study. Spine. 2007;32(1):120–5.CrossRefPubMed
2.
Kelleher MO, Timlin M, Persaud O, Rampersaud YR. Success and failure of minimally invasive decompression for focal lumbar spinal stenosis in patients with and without deformity. Spine. 2010;35(19):E981–7.CrossRefPubMed
3.
Kepler CK, Vaccaro AR, Hilibrand AS, Anderson DG, Rihn JA, Albert TJ, et al. National trends in the use of fusion techniques to treat degenerative spondylolisthesis. Spine. 2014;39(19):1584–9.CrossRefPubMed
4.
Schroeder GD, Kepler CK, Kurd MF, Vaccaro AR, Hsu WK, Patel AA, Savage JW. Rationale for the Surgical Treatment of Lumbar Degenerative Spondylolisthesis. Spine (Phila Pa 1976). 2015;40(21):E1161–6.
5.
Herkowitz HN, Kurz LT. Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. J Bone Joint Surg Am. 1991;73(6):802–8.CrossRefPubMed
6.
Bridwell KH, Sedgewick TA, O’Brien MF, Lenke LG, Baldus C. The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis. J Spinal Disord. 1993;6(6):461–72.CrossRefPubMed
7.
Kornblum MB, Fischgrund JS, Herkowitz HN, Abraham DA, Berkower DL, Ditkoff JS. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective long-term study comparing fusion and pseudarthrosis. Spine. 2004;29(7):726–33.CrossRefPubMed
8.
•• Mummaneni PV, Dhall SS, Eck JC, Groff MW, Ghogawala Z, Watters WC, et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 11: interbody techniques for lumbar fusion. J Neurosurg Spine. 2014;21(1):67–74. The American Association of Neurological Surgeons / Congress of Neurological Surgeons (AANS/CNS) Joint Section on Disorders of the Spine and Peripheral Nerves released updated clinical practice guidelines in 2014. These included a Grade B recommendation that interbody techniques are associated with increased fusion rates and fewer reoperations (but not necessarily improved radiographic or clinical outcomes) in patients with DLS and pre-operative instability. CrossRefPubMed
9.
Gibson JNA, Waddell G. Surgery for degenerative lumbar spondylosis: updated Cochrane Review. Spine. 2005;30(20):2312–20.CrossRefPubMed
10.
•• Matz PG, Meagher RJ, Lamer T, Tontz WL, Annaswamy TM, Cassidy RC, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J Off J North Am Spine Soc. 2016;16(3):439–48. The North American Spine Society (NASS) released evidence-based clinical practice guidelines for the diagnosis and treatment of DLS in 2016. The work group was unable to draw conclusions regarding the overall merit of IBF in the surgical treatment of DLS due to insufficient evidence. CrossRef
11.
Oda I, Abumi K, Yu B-S, Sudo H, Minami A. Types of spinal instability that require interbody support in posterior lumbar reconstruction: an in vitro biomechanical investigation. Spine. 2003;28(14):1573–80.PubMed
12.
McAfee PC, DeVine JG, Chaput CD, Prybis BG, Fedder IL, Cunningham BW, et al. The indications for interbody fusion cages in the treatment of spondylolisthesis: analysis of 120 cases. Spine. 2005;30(6 Suppl):S60–5.CrossRefPubMed
13.
Liao J-C, Lu M-L, Niu C-C, Chen W-J, Chen L-H. Surgical outcomes of degenerative lumbar spondylolisthesis with anterior vacuum disc: can the intervertebral cage overcome intradiscal vacuum phenomenon and enhance posterolateral fusion? J Orthop Sci Off J Jpn Orthop Assoc. 2014;19(6):851–9.
14.
Ha K-Y, Na K-H, Shin J-H, Kim K-W. Comparison of posterolateral fusion with and without additional posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis. J Spinal Disord Tech. 2008;21(4):229–34.CrossRefPubMed
15.
Vamvanij V, Ferrara LA, Hai Y, Zhao J, Kolata R, Yuan HA. Quantitative changes in spinal canal dimensions using interbody distraction for spondylolisthesis. Spine. 2001;26(3):E13–8.CrossRefPubMed
16.
Macki M, Bydon M, Weingart R, Sciubba D, Wolinsky J-P, Gokaslan ZL, et al. Posterolateral fusion with interbody for lumbar spondylolisthesis is associated with less repeat surgery than posterolateral fusion alone. Clin Neurol Neurosurg. 2015;138:117–23.CrossRefPubMed
17.
Marchi L, Abdala N, Oliveira L, Amaral R, Coutinho E, Pimenta L. Stand-alone lateral interbody fusion for the treatment of low-grade degenerative spondylolisthesis. ScientificWorldJournal. 2012;2012:456346.CrossRefPubMedPubMedCentral
18.
Rao PJ, Ghent F, Phan K, Lee K, Reddy R, Mobbs RJ. Stand-alone anterior lumbar interbody fusion for treatment of degenerative spondylolisthesis. J Clin Neurosci. 2015;22(10):1619–24.
19.
Gille O, Challier V, Parent H, Cavagna R, Poignard A, Faline A, et al. Degenerative lumbar spondylolisthesis. Cohort of 670 patients, and proposal of a new classification. Orthop Traumatol Surg Res. 2014;100(6):S311–5.CrossRefPubMed
20.
• Norton RP, Bianco K, Klifto C, Errico TJ, Bendo JA. Degenerative spondylolisthesis: an analysis of the nationwide inpatient sample database. Spine. 2015;40(15):1219–27. This analysis of a large nationwide database compared inpatient complication rates between P/TLIF and A/LLIF patients being treated for DLS. Patients undergoing interbody fusion via an anterior or lateral approach were significantly less likely to develop acute blood loss anemia but were at significantly higher risk of gastrointestinal complications than those undergoing P/TLIF. CrossRefPubMed
21.
Abdu WA, Lurie JD, Spratt KF, Tosteson ANA, Zhao W, Tosteson TD, et al. Degenerative spondylolisthesis: does fusion method influence outcome? Four-year results of the spine patient outcomes research trial. Spine. 2009;34(21):2351–60.CrossRefPubMedPubMedCentral
22.
Baker JF, Errico TJ, Kim Y, Razi A. Degenerative spondylolisthesis: contemporary review of the role of interbody fusion. Eur J Orthop Surg Traumatol Orthop Traumatol. 2016;
23.
Li Y-C, Yang S-C, Chen H-S, Kao Y-H, Tu Y-K. Impact of lumbar instrumented circumferential fusion on the development of adjacent vertebral compression fracture. Bone Jt J. 2015;97–B(10):1411–6.CrossRef
24.
Lee JC, Kim Y, Soh J-W, Shin B-J. Risk factors of adjacent segment disease requiring surgery after lumbar spinal fusion: comparison of posterior lumbar interbody fusion and posterolateral fusion. Spine. 2014;39(5):E339–45.CrossRefPubMed
25.
Videbaek TS, Egund N, Christensen FB, Grethe Jurik A, Bünger CE. Adjacent segment degeneration after lumbar spinal fusion: the impact of anterior column support: a randomized clinical trial with an eight- to thirteen-year magnetic resonance imaging follow-up. Spine. 2010;35(22):1955–64.CrossRefPubMed
26.
Sudo H, Oda I, Abumi K, Ito M, Kotani Y, Hojo Y, et al. In vitro biomechanical effects of reconstruction on adjacent motion segment: comparison of aligned/kyphotic posterolateral fusion with aligned posterior lumbar interbody fusion/posterolateral fusion. J Neurosurg. 2003;99(2 Suppl):221–8.PubMed
27.
Heo Y, Park JH, Seong HY, Lee YS, Jeon SR, Rhim SC, Roh SW. Symptomatic adjacent segment degeneration at the L3-4 level after fusion surgery at the L4-5 level: evaluation of the risk factors and 10-year incidence. Eur Spine J. 2015;24(11):2474–80.
28.
Eismont FJ, Norton RP, Hirsch BP. Surgical management of lumbar degenerative spondylolisthesis. J Am Acad Orthop Surg. 2014;22(4):203–13.CrossRefPubMed
29.
Ikard RW. Methods and complications of anterior exposure of the thoracic and lumbar spine. Arch Surg. 2006;141(10):1025–34.CrossRefPubMed
30.
Nourian AA, Cunningham CM, Bagheri A, Bruffey JD, Eastlack RK. Effect of anatomic variability and level of approach on perioperative vascular complications with anterior lumbar interbody fusion. Spine (Phila Pa 1976). 2016;41(2):E73–7.
31.
Malham GM, Parker RM, Ellis NJ, Blecher CM, Chow FY, Claydon MH. Anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2: a prospective study of complications. J Neurosurg Spine. 2014;21(6):851–60.CrossRefPubMed
32.
Cole CD, McCall TD, Schmidt MH, Dailey AT. Comparison of low back fusion techniques: transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) approaches. Curr Rev Musculoskelet Med. 2009;2(2):118–26.CrossRefPubMedPubMedCentral
33.
Steiger F, Becker H-J, Standaert CJ, Balague F, Vader J-P, Porchet F, et al. Surgery in lumbar degenerative spondylolisthesis: indications, outcomes and complications. A systematic review. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2014;23(5):945–73.CrossRef
34.
Fantini GA, Pappou IP, Girardi FP, Sandhu HS, Cammisa FP. Major vascular injury during anterior lumbar spinal surgery: incidence, risk factors, and management. Spine. 2007;32(24):2751–8.CrossRefPubMed
35.
Lara-Almunia M, Gomez-Moreta JA, Hernandez-Vicente J. Posterior lumbar interbody fusion with instrumented posterolateral fusion in adult spondylolisthesis: description and association of clinico-surgical variables with prognosis in a series of 36 cases. Int J Spine Surg. 2015;9:22.PubMedPubMedCentral
36.
• Pawar AY, Hughes AP, Sama AA, Girardi FP, Lebl DR, Cammisa FP. A comparative study of lateral lumbar interbody fusion and posterior lumbar interbody fusion in degenerative lumbar spondylolisthesis. Asian Spine J. 2015;9(5):668–74. This retrospective matched cohort study compared LLIF (n = 39) to PLIF (n = 39) for 1- or 2-level DLS. Authors found that LLIF resulted in improved radiologic outcomes (restoration of foraminal height, disc height, and lumbar lordosis) with less average blood loss and fewer intra-operative dural tears than PLIF. There was also significantly greater improvement in ODI scores with LLIF, but no other significant differences in clinical outcome scores between groups.
37.
Zhang Q, Yuan Z, Zhou M, Liu H, Xu Y, Ren Y. A comparison of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion: a literature review and meta-analysis. BMC Musculoskelet Disord. 2014;15:367.CrossRefPubMedPubMedCentral
38.
Harms J, Rolinger H. A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author’s transl). Z Für Orthop Ihre Grenzgeb. 1982;120(3):343–7.CrossRef
39.
Chrastil J, Patel AA. Complications associated with posterior and transforaminal lumbar interbody fusion. J Am Acad Orthop Surg. 2012;20(5):283–91.CrossRefPubMed
40.
Tender GC, Miller LE, Block JE. Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: A case series. J Med Case Rep. 2011;5:454.CrossRefPubMedPubMedCentral
41.
Ozgur BM, Aryan HE, Pimenta L, Taylor WR. Extreme Lateral Interbody Fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J Off J North Am Spine Soc. 2006;6(4):435–43.CrossRef
42.
Fogel GR, Turner AWL, Dooley ZA, Cornwall GB. Biomechanical stability of lateral interbody implants and supplemental fixation in a cadaveric degenerative spondylolisthesis model. Spine. 2014;39(19):E1138–46.CrossRefPubMed
43.
Karikari IO, Nimjee SM, Hardin CA, Hughes BD, Hodges TR, Mehta AI, et al. Extreme lateral interbody fusion approach for isolated thoracic and thoracolumbar spine diseases: initial clinical experience and early outcomes. J Spinal Disord Tech. 2011;24(6):368–75.CrossRefPubMed
44.
Khajavi K, Shen A, Lagina M, Hutchison A. Comparison of clinical outcomes following minimally invasive lateral interbody fusion stratified by preoperative diagnosis. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2015;24(Suppl 3):322–30.CrossRef
45.
Hrabalek L, Adamus M, Gryga A, Wanek T, Tucek P. A comparison of complication rate between anterior and lateral approaches to the lumbar spine. Biomed Pap Med Fac Univ Palacký Olomouc Czechoslov. 2014;158(1):127–32.
46.
Issack PS, Kotwal SY, Boachie-Adjei O. The axial transsacral approach to interbody fusion at L5-S1. Neurosurg Focus. 2014;36(5):E8.CrossRefPubMed
47.
Marotta N, Cosar M, Pimenta L, Khoo LT. A novel minimally invasive presacral approach and instrumentation technique for anterior L5-S1 intervertebral discectomy and fusion: technical description and case presentations. Neurosurg Focus. 2006;20(1):E9.CrossRefPubMed
48.
Schroeder GD, Kepler CK, Vaccaro AR. Axial interbody arthrodesis of the L5-S1 segment: a systematic review of the literature. J Neurosurg Spine. 2015;23(3):314–9.
49.
Lindley EM, McCullough MA, Burger EL, Brown CW, Patel VV. Complications of axial lumbar interbody fusion. J Neurosurg Spine. 2011;15(3):273–9.CrossRefPubMed
50.
Mazur MD, Duhon BS, Schmidt MH, Dailey AT. Rectal perforation after AxiaLIF instrumentation: case report and review of the literature. Spine J Off J North Am Spine Soc. 2013;13(11):e29–34.CrossRef
51.
Botolin S, Agudelo J, Dwyer A, Patel V, Burger E. High rectal injury during trans-1 axial lumbar interbody fusion L5-S1 fixation: a case report. Spine. 2010;35(4):E144–8.CrossRefPubMed
52.
Yan D-L, Pei F-X, Li J, Soo C-L. Comparative study of PILF and TLIF treatment in adult degenerative spondylolisthesis. Eur Spine J. 2008;17(10):1311–6.CrossRefPubMedPubMedCentral
53.
• Liu J, Deng H, Long X, Chen X, Xu R, Liu Z. A comparative study of perioperative complications between transforaminal versus posterior lumbar interbody fusion in degenerative lumbar spondylolisthesis. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2015;This retrospective cohort study compared TLIF (n = 101) and PLIF (n = 125) in the treatment of 1- or 2-level Grade I–II DLS. Authors reported that PLIF and TLIF produce similar short-term functional improvements, but PLIF is associated with significantly more operative morbidity (blood loss, dural tear) and peri-operative complications (nerve root dysfunction, allogenic blood transfusion, reoperation due to infection and nerve root injury). The groups experienced similar improvement in pain and functional outcomes 1 week post-operatively.
54.
• Sembrano JN, Tohmeh A, Isaacs R, SOLAS Degenerative Study Group. two-year comparative outcomes of mis lateral and mis transforaminal interbody fusion in the treatment of degenerative spondylolisthesis: part I: clinical findings. Spine. 2016;41(Suppl 8):S123–32. This manuscript reported the two-year clinical outcomes of a prospective cohort study comparing LLIF (n = 29) to MIS TLIF (n = 26) in the treatment of 1- or 2-level Grade I-II DLS. There was significantly less blood loss with LLIF, no difference in operative time or hospital length of stay, and similar improvements in pain, disability and quality of life scores. 31% of LLIF patients (and no TLIF patients) had mild, transient post-operative hip flexion weakness. PubMed
55.
• Isaacs RE, Sembrano JN, Tohmeh AG, SOLAS Degenerative Study Group. Two-year comparative outcomes of mis lateral and mis transforaminal interbody fusion in the treatment of degenerative spondylolisthesis: part II: radiographic findings. Spine. 2016;41(Suppl 8):S133–44. This manuscript reported the two-year radiographic outcomes of a prospective cohort study comparing LLIF (n = 29) to MIS TLIF (n = 26) in the treatment of 1- or 2-level Grade I-II DLS. Authors observed a greater post-operative increase in central canal area with TLIF, but there was less subsidence in the LLIF group at two-year follow up. All LLIF patients and 96% of TLIF patients had evidence of fusion on computed tomography (p = 0.448). PubMed
Metadaten
Titel
Interbody Fusion Techniques in the Surgical Management of Degenerative Lumbar Spondylolisthesis
verfasst von
Peter B. Derman
Todd J. Albert
Publikationsdatum
26.10.2017
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 4/2017
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-017-9443-2

Weitere Artikel der Ausgabe 4/2017

Current Reviews in Musculoskeletal Medicine 4/2017 Zur Ausgabe

Treatment of Lumbar Degenerative Pathology (HJ Kim and G Mundis, section editors)

Degenerative Scoliosis

Management of Anterior Shoulder Instability (X Li, section editor)

Applying the Glenoid Track Concept in the Management of Patients with Anterior Shoulder Instability

Treatment of Lumbar Degenerative Pathology (HJ Kim and G Mundis, section editors)

Lateral Lumbar Interbody Fusion—Outcomes and Complications

Treatment of Lumbar Degenerative Pathology (HJ Kim and G Mundis, section editors)

Minimally invasive techniques for lumbar decompressions and fusions

Management of Anterior Shoulder Instability (X Li, section editor)

Management of Glenoid Bone Loss with Anterior Shoulder Instability: Indications and Outcomes

Management of Anterior Shoulder Instability (X Li, section editor)

Arthroscopic Bankart Repair for the Management of Anterior Shoulder Instability: Indications and Outcomes

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

25.04.2024 | Hypertonie | Nachrichten

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Ärztliche Empathie hilft gegen Rückenschmerzen

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

16.04.2024 | Spondylitis ankylosans | Nachrichten

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!
weitere anzeigen

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise