The online version of this article (https://doi.org/10.1007/s00586-020-06303-z) contains supplementary material, which is available to authorized users.
The study was partially funded by a grant from the Society of Lateral Access Surgery (SOLAS) and funds from the Italian Ministry of Health.
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Single-position options for combined anterior and posterior fusion in the lumbar spine have been suggested to reduce the surgical time and improve the efficiency of operating room. Previous reports have focused on lateral decubitus single-position surgery. The goal of this study is to describe and evaluate the feasibility and safety of prone single-position extreme lateral interbody fusion (XLIF) with posterior fixation.
Design Pilot prospective non-randomized controlled study. Seven patients who underwent prone single-position XLIF and posterior fixation were evaluated (Pro-XLIF). A control group (Std-XLIF) was composed of ten patients who underwent XLIF in lateral decubitus and posterior fixation in prone position. All patients underwent interbody XLIF fusion at one level and posterior procedures at one or more levels. Duration of surgery, blood loss, complications, X-ray use and clinical outcomes were recorded.
No major complications were observed in either group. Oswestry Disability Index, back pain and leg pain were improved in the Pro-XLIF group from 48.5, 7.7 and 8.5 to 14.5, 1.71 and 2.71, respectively, and in the Std-XLIF group from 50.8, 5.7 and 7.2 to 22.5, 3.7 and 2.5. The Pro-XLIF group had a longer time of preparation before incision (39 vs 26 min, ns), equal duration of the anterior procedure (65 vs 59 min, ns), shorter duration of surgery (133 vs 182 min, ns) and longer X-ray exposure time (102 vs 92 s, ns). The surgical technique is described.
Prone single-position XLIF is feasible and safe. In this preliminary report, the results are comparable to the standard technique.
These slides can be retrieved under Electronic Supplementary Material.
Ozgur BM, Aryan HE, Pimenta L, Taylor WR (2006) Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J 6:435–443 CrossRef
Dominguez I, Luque R, Noriega M, Rey J, Alia J, Marco-Martinez F (2018) Extreme lateral lumbar interbody fusion. Surgical technique, outcomes and complications after a minimum of 1-year follow-up. Rev Esp Cir Ortop Traumatol 61(1):8–18
Tessitore E, Molliqaj G, Schaller K, Gautschi OP (2017) Extreme lateral interbody fusion (XLIF): a single-center clinical and radiological follow-up study of 20 patients. J Clin Neurosci 36:76–79 CrossRef
Pereira EAC, Farwana M, Lam KS (2017) Extreme lateral interbody fusion relieves symptoms of spinal stenosis and low-grade spondylolisthesis by indirect decompression in complex patients. J Clin Neurosci 35:56–61 CrossRef
Tohmeh AG, Khorsand D, Watson B, Zielinski X (2014) Radiographical and clinical evaluation of extreme lateral interbody fusion. Spine 39:E1582–E1591 CrossRef
Castellvi AE, Nienke TW, Marulanda GA, Murtagh RD, Santoni BG (2014) Indirect decompression of lumbar stenosis with transpsoas interbody cages and percutaneous posterior instrumentation. Clin Orthop Relat Res 472:1784–1791 CrossRef
Alimi M, Hofstetter CP, Tsiouris AJ, Elowitz E, Hartl R (2015) Extreme lateral interbody fusion for unilateral symptomatic vertical foraminal stenosis. Eur Spine J 24(Suppl 3):346–352 CrossRef
Rodgers W, Cox C, Gerber E (2009) Minimally invasive treatment (XLIF) of adjacent segment disease after prior lumbar fusion. Internet J Minim Invasive Spinal Technol (IJMIST) 3:4
Formica M, Berjano P, Cavagnaro L, Zanirato A, Piazzolla A, Formica C (2014) Extreme lateral approach to the spine in degenerative and post traumatic lumbar disease: selection process, results and complications. Eur Spine J 23(Suppl 6):648–692
Cappuccino A, Cornwall GB, Turner AW, Fogel GR, Duong HT, Kim KD, Brodke DS (2010) Biomechanical analysis and review of lateral lumbar fusion constructs. Spine (Phila Pa 1976) 35:S361–S367 CrossRef
Nayak AN, Gutierrez S, Billys JB, Santoni BG, Castellvi AE (2013) Biomechanics of lateral plate and pedicle screw constructs in lumbar spines instrumented at two levels with laterally placed interbody cages. Spine J. 13:1331–1338 CrossRef
Berjano P, Gautschi OP, Schils F, Tessitore E (2015) Extreme lateral interbody fusion (XLIF): how I do it. Acta Neurochir 157:547–551 CrossRef
Quiceno E, Hartman C, Godzik J, Pacult MA, Hemphill C, Uribe JS (2019) Single position spinal surgery for the treatment of grade II spondylolisthesis: a technical note. J Clin Neurosci 65:145–147. https://doi.org/10.1016/j.jocn.2019.03.016 CrossRefPubMed
Walker CT, Farber SH, Cole TS, Xu DS, Godzik J, Whiting AC, Hartman C, Porter RW, Turner JD, Uribe J (2019) Complications for minimally invasive lateral interbody arthrodesis: a systematic review and meta-analysis comparing prepsoas and transpsoas approaches. J Neurosurg Spine 25:1–15 CrossRef
Khajavi K, Shen A, Lagina M, Hutchinson A (2015) Comparison of clinical outcomes following minimally invasive lateral interbody fusion stratified by preoperative diagnosis. Eur Spine J 24(Suppl 3):322–330 CrossRef
- Prone single-position extreme lateral interbody fusion (Pro-XLIF): preliminary results
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