Menu
Menu
19 Harley St, London, W1G 9QJ, UK

160?Failure of Indirect Decompression With the Extreme Lateral Interbody (XLIF) Approach: A Study of Radiographic Factors.

160?Failure of Indirect Decompression With the Extreme Lateral Interbody (XLIF) Approach: A Study of Radiographic Factors.

Neurosurgery. 2013 Aug;60 Suppl 1:173

Authors: Karikari I, Adogwa O, Owens TR, Thompson P, Isaacs RE

Abstract
INTRODUCTION: The XLIF procedure provides a unique access to the anterior thoracic and lumbar spine through a lateral transpsoas approach, and has become a key component of the spine surgeon’s armamentarium. Symptomatic lumbar central, lateral recess and foraminal stenosis remain the most common indication for the procedure. The purpose of this study is to determine the radiological factors that are predictive of failure of indirect decompression with the XLIF procedure.
METHODS: A retrospective review of 40 consecutive patient’s pre-operative, postoperative and 3- and 6-month follow-up radiographs was performed. The primary outcome was to determine the independent variables predictive of achieving a minimum 30% change from baseline in sagittal vertebral canal diameter, a threshold above while we defined as ‘success’ of indirect decompression.
RESULTS: The median [Inter Quartile Range] number of levels decompressed was 2 [1 2]. Overall, the mean ± SD right and left subarticular distance at L4 L5 was 2.09 ± 1.29 mm and 1.98 ± 1.25, respectively, Table 2. Overall, the mean ± SD anterior and posterior disc height at L4 L5 was 8.23 ± 3.37 mm and 6.14 ± 2.02 mm, respectively, Table 3. In a univariate regression analysis younger patient age, intervertebral disc height, foraminal area, anterior disc height, number of levels fused, posterior disc height, central canal and diameter and Facet Arthopathy grade were all significantly associated with successful indirect decompression. However, in a multivariate logistic regression model, increasing right and left subarticular diameters greater than 2.25 mm and 2.35 mm, respectively, and an axial central canal diameter greater than 123.1 mm remained independently predictive of successful indirect decompression (> 30% change in sagittal canal diameter).
CONCLUSION: Our study suggests that independent of a technically excellent surgery, increasing pre-operative subarticular length and axial central canal diameter are predictive of successful indirect decompression (>30% change in sagittal canal diameter).

PMID: 23839427 [PubMed – in process]

160 Failure of Indirect Decompression With the Extreme Lateral Interbody (XLIF) Approach: A Study of Radiographic Factors.

Neurosurgery. 2013 Aug;60 Suppl 1:173

Authors: Karikari I, Adogwa O, Owens TR, Thompson P, Isaacs RE

Abstract
INTRODUCTION: The XLIF procedure provides a unique access to the anterior thoracic and lumbar spine through a lateral transpsoas approach, and has become a key component of the spine surgeon's armamentarium. Symptomatic lumbar central, lateral recess and foraminal stenosis remain the most common indication for the procedure. The purpose of this study is to determine the radiological factors that are predictive of failure of indirect decompression with the XLIF procedure.
METHODS: A retrospective review of 40 consecutive patient's pre-operative, postoperative and 3- and 6-month follow-up radiographs was performed. The primary outcome was to determine the independent variables predictive of achieving a minimum 30% change from baseline in sagittal vertebral canal diameter, a threshold above while we defined as 'success' of indirect decompression.
RESULTS: The median [Inter Quartile Range] number of levels decompressed was 2 [1 2]. Overall, the mean ± SD right and left subarticular distance at L4 L5 was 2.09 ± 1.29 mm and 1.98 ± 1.25, respectively, Table 2. Overall, the mean ± SD anterior and posterior disc height at L4 L5 was 8.23 ± 3.37 mm and 6.14 ± 2.02 mm, respectively, Table 3. In a univariate regression analysis younger patient age, intervertebral disc height, foraminal area, anterior disc height, number of levels fused, posterior disc height, central canal and diameter and Facet Arthopathy grade were all significantly associated with successful indirect decompression. However, in a multivariate logistic regression model, increasing right and left subarticular diameters greater than 2.25 mm and 2.35 mm, respectively, and an axial central canal diameter greater than 123.1 mm remained independently predictive of successful indirect decompression (> 30% change in sagittal canal diameter).
CONCLUSION: Our study suggests that independent of a technically excellent surgery, increasing pre-operative subarticular length and axial central canal diameter are predictive of successful indirect decompression (>30% change in sagittal canal diameter).

PMID: 23839427 [PubMed - in process]

What our patients say ...

Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Anaesthetist

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

Laser Spine Surgery Articles

SHADES of grey – The challenge of ‘grumbling’ cauda equina symptoms in older adults with lumbar spinal stenosis.
Abstract Diagnosing cauda equina syndrome is challenging in older adults with lumbar spinal stenosis. Understanding these challenges is vital for
Read more.
The influence of preoperative mental health on clinical outcomes after laminectomy in patients with lumbar spinal stenosis.
Abstract OBJECTIVE: The influence of preoperative mental health on health-related quality of life (HRQOL) in patients with lumbar spinal stenosis
Read more.
MicroRNA transcriptome analysis on hypertrophy of ligamentum flavum in patients with lumbar spinal stenosis.
Abstract Introduction: Molecular pathways involved in ligamentum flavum (LF) hypertrophy are still unclarified. The purpose of this study was to
Read more.
Salvage Strategy for Failed Spinal Fusion Surgery Using Lumbar Lateral Interbody Fusion technique: A Technical Note.
Abstract Introduction: Failed spinal fusion surgery sometimes requires salvage surgery when symptomatic, especially with postsurgical decrease in intervertebral disc height
Read more.
Integrated anatomy of the neuromuscular, visceral, vascular, and urinary tissues determined by MRI for a surgical approach to lateral lumbar
Abstract Introduction: To comprehensively investigate the anatomy of the neuromuscular, visceral, vascular, and urinary tissues and their general influence on
Read more.
Clinical Outcomes of Treating Cervical Adjacent Segment Disease by Anterior Cervical Discectomy and Fusion Versus Total Disc Replacement: A Systematic
Related Articles Clinical Outcomes of Treating Cervical Adjacent Segment Disease by Anterior Cervical Discectomy and Fusion Versus Total Disc Replacement:
Read more.

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810