Related Articles
[Case-control study of therapeutic effects between extreme lateral interbody fusion and conventional posterior operation for the treatment of upper lumbar disc herniation].
Zhongguo Gu Shang. 2017 Nov 25;30(…

Related Articles
[Case-control study of therapeutic effects between extreme lateral interbody fusion and conventional posterior operation for the treatment of upper lumbar disc herniation].
Zhongguo Gu Shang. 2017 Nov 25;30(…

Revision surgery for degenerative spinal deformity: a case report and review of the literature.
Spinal Cord Ser Cases. 2017;3:17085
Authors: Donnarumma P, Tarantino R, Nigro L, Fragale M, Bassani R, Delfini R

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[The shor-term clinical outcomes and safety of extreme lateral interbody fusion combined with percutaneous pedicle screw fixation for the treatment of degenerative lumbar disease].
Zhongguo Gu Shang. 2017 Fe…

Related Articles
[The shor-term clinical outcomes and safety of extreme lateral interbody fusion combined with percutaneous pedicle screw fixation for the treatment of degenerative lumbar disease].
Zhongguo Gu Shang. 2017 Fe…

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Comparison of serum markers for muscle damage, surgical blood loss, postoperative recovery, and surgical site pain after extreme lateral interbody fusion with percutaneous pedicle screws or traditional open posterior lumbar interbody fusion.

BMC Musculoskelet Disord. 2017 Oct 16;18(1):415

Authors: Ohba T, Ebata S, Haro H

Abstract
BACKGROUND: The benefits of extreme lateral interbody fusion (XLIF) as a minimally invasive lumbar spinal fusion treatment for lumbar degenerative spondylolisthesis have been unclear. We sought to evaluate the invasiveness and tolerability of XLIF with percutaneous pedicle screws (PPS) compared with traditional open posterior lumbar interbody fusion (PLIF).
METHODS: Fifty-six consecutive patients underwent open PLIF and 46 consecutive patients underwent single-staged treatment with XLIF with posterior PPS fixation for degenerative lumbar spondylolisthesis, and were followed up for a minimum of 1 year. We analyzed postoperative serum makers for muscle damage and inflammation, postoperative surgical pain, and performance status. A Roland-Morris Disability Questionnaire (RDQ) and Oswestry Disability Index (ODI) were obtained at the time of hospital admission and 1 year after surgery.
RESULTS: Intraoperative blood loss (51 ± 41 ml in the XLIF/PPS group and 206 ± 191 ml in the PLIF group), postoperative WBC counts and serum CRP levels in the XLIF/PPS group were significantly lower than in the PLIF group. Postoperative serum CK levels were significantly lower in the XLIF/PPS group on postoperative days 4 and 7. Postoperative recovery of performance was significantly greater in the XLIF/PPS group than in the PLIF group from postoperative days 2 to 7. ODI and visual analog scale (VAS) score (lumbar) 1 year after surgery were significantly lower in the XLIF/PPS group compared with the PLIF group.
CONCLUSIONS: The XLIF/PPS procedure is advantageous to minimize blood loss and muscle damage, with consequent earlier recovery of daily activities and reduced incidence of low back pain after surgery than with the open PLIF procedure.

PMID: 29037186 [PubMed – in process]

A Novel Lumbar Motion Segment Classification to Predict Changes in Segmental Sagittal Alignment After Lateral Interbody Fixation.
Global Spine J. 2017 Oct;7(7):642-647
Authors: Acosta FL, Mehta VA, Arakelyan A, Dra…

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Potential and Limitations of Neural Decompression in Extreme Lateral Interbody Fusion-A Systematic Review.

World Neurosurg. 2017 May;101:99-113

Authors: Lang G, Perrech M, Navarro-Ramirez R, Hussain I, Pennicooke B, Maryam F, Avila MJ, Härtl R

Abstract
BACKGROUND: Extreme lateral interbody fusion (ELIF) is a powerful tool for interbody fusion and coronal deformity correction. However, evidence regarding the success of ELIF in decompressing foraminal, lateral recess, and central canal stenosis is lacking. We performed a systematic review of current literature on the potential and limitations of ELIF to indirectly decompress neural elements.
METHODS: A literature search using PubMed, Cochrane, and ScienceDirect databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Information on study design, sample size, population, procedure, number and location of involved levels, follow-up time, and complications as well as information on conflict of interest was extracted and evaluated.
RESULTS: We selected 20 publications including 1080 patients for review. Most publications (90%) were retrospective case series. Most frequent indications for ELIF included degenerative disc disease, spinal stenosis, spondylolisthesis, and degenerative scoliosis. Most studies revealed significant improvement in radiographic and clinical outcome after ELIF. Mean foraminal area, central canal area, and subarticular diameter increased by 31.6 mm(2), 28.5 mm(2), and 0.85 mm. ELIF successfully improved foraminal stenosis. Contradictory results were found for indirect decompression of central canal stenosis. Data on lateral recess stenosis were scarce.
CONCLUSIONS: Current data suggest ELIF to be an efficient technique in decompression of foraminal stenosis. Evidence on decompression of central canal or lateral recess stenosis via ELIF is low, and results are inconsistent. Most studies are limited by study design, sample size, and potential conflicts of interest.

PMID: 28153620 [PubMed – indexed for MEDLINE]

[A MRI study of lumbar plexus in patients with degenerative lumbar scoliosis after extreme lateral interbody fusion].

Zhonghua Yi Xue Za Zhi. 2014 Jan 21;94(3):178-81

Authors: He L, Dong J, Liu B, Chen R, Feng F, Rong L

Abstract
OBJECTIVE: To analyze the magnetic resonance neural imaging distribution of lumbar plexus in patients with degenerative lumbar scoliosis and evaluate its value and the safety of extreme lateral interbody fusion (XLIF).
METHODS: Three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) sequences of lumbar spine were scanned on 19 patients with degenerative lumbar scoliosis, including levoscoliosis (n = 11) and dextroscoliosis (n = 8). All images were sent to workstation for multiplanar volume reconstruction to analyze the distribution of lumbar plexus from L1-2 to L4-5 level. The axial image distance (AID) was measured between anterior edge of lumbar plexus and sagittal central perpendicular line (SCPL). SCPL was drawn perpendicularly to the sagittal plane of intervertebral disc and passed through its central point. It was actually the pathway of guide wire implanting procedure and the ongoing axis of work channel during XLIF. With respect to SCPL, the distance with a positive value indicated posterior neural tissue whereas a negative value anterior neural tissue. The differences of AID were compared between convex and concave sides and among different cases and levels.
RESULTS: From L1-2 to L4-5 level, the AID on the concave side in levoscoliosis or dextroscoliosis cases was (13.7 ± 2.5) mm/ (12.9 ± 5.5) mm, (8.3 ± 4.7) mm/ (8.5 ± 5.7) mm, (2.7 ± 3.6) mm/ (2.5 ± 7.2) mm and (-4.2 ± 3.8) mm/ (-3.8 ± 7.1) mm respectively. They were located significantly posteriorly to the relevant disc compared to those on the convex side at the same intervertebral space (P < 0.05). The differences of AID at the same side, concave or convex side, was significant (P < 0.05). No significant differences of lumbar plexus distribution existed between levoscoliosis and dextroscoliosis cases (P > 0.05).
CONCLUSION: Lumbar plexus passes through psoas posteriorly to SCPL on both side at L1-2, L2-3 level and on the concave side at L3-4 level. And they shift anteriorly to SCPL on the convex side at L3-4 level and on both sides at L4-5 level. It indicates a ventral migration of lumbar plexus from L1-2 to L4-5 level. Preoperative magnetic resonance neural imaging is valuable for assessing the safety of XLIF approach. Operation from the concave may reduce the risk of injury to lumbar plexus.

PMID: 24731457 [PubMed – in process]

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Lumbar Lateral Interbody Fusion (LLIF): Comparative Effectiveness and Safety versus PLIF/TLIF and Predictive Factors Affecting LLIF Outcome.

Evid Based Spine Care J. 2014 Apr;5(1):28-37

Authors: Barbagallo GM, Albanese V, Raich AL, Dettori JR, Sherry N, Balsano M

Abstract
Study Design Systematic review. Study Rationale The surgical treatment of adult degenerative lumbar conditions remains controversial. Conventional techniques include posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). A new direct approach known as lumbar lateral interbody fusion (LLIF), or extreme lateral interbody fusion (XLIF(®)) or direct lateral interbody fusion (DLIF), has been introduced. Objectives The objective of this article is to determine the comparative effectiveness and safety of LLIF, at one or more levels with or without instrumentation, versus PLIF or TLIF surgery in adults with lumbar degenerative conditions, and to determine which preoperative factors affect patient outcomes following LLIF surgery. Materials and Methods A systematic review of the literature was performed using PubMed and bibliographies of key articles. Articles were reviewed by two independent reviewers based on predetermined inclusion and exclusion criteria. Each article was evaluated using a predefined quality rating scheme. Results The search yielded 258 citations and the following met our inclusion criteria: three retrospective cohort studies (all using historical cohorts) (class of evidence [CoE] III) examining the comparative effectiveness and safety of LLIF/XLIF(®)/DLIF versus PLIF or TLIF surgery, and one prospective cohort study (CoE II) and two retrospective cohort studies (CoE III) assessing factors affecting patient outcome following LLIF. Patients in the LLIF group experienced less estimated blood loss and a lower mortality risk compared with the PLIF group. The number of levels treated and the preoperative diagnosis were significant predictors of perioperative or early complications in two studies. Conclusion There is insufficient evidence of the comparative effectiveness of LLIF versus PLIF/TLIF surgery. There is low-quality evidence suggesting that LLIF surgery results in fewer complications or reoperations than PLIF/TLIF surgery. And there is insufficient evidence that any preoperative factors exist that predict patient outcome after LLIF surgery.

PMID: 24715870 [PubMed – as supplied by publisher]

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