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Lateral approach to the lumbar spine: The utility of an access surgeon – Lumbar Fusion

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The article examines the outcomes of lateral lumbar interbody fusions (LLIFs) performed by either spine surgeons or access surgeons. LLIFs are a surgical technique that involves approaching the lumbar spine through a retroperitoneal approach to avoid manipulation of intraperitoneal organs and anterior vasculature. The study retrospectively analyzed data from a tertiary care center between 2011 and 2021, specifically looking at hospital readmissions and complication rates. The results showed that there were no significant differences in postoperative complication rates between the two groups. However, the spine surgeon group had shorter surgeries and hospital stays, primarily due to a shorter posterior fusion construct. In , the study suggests that similar outcomes can be achieved regardless of whether a spine surgeon or access surgeon performs the LLIF approach

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: Similar outcomes may be seen regardless of whether a spine or access surgeon performs the approach for an LLIF.

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J Craniovertebr Junction Spine. 2023 Jul-Sep;14(3):281-287. doi: 10.4103/jcvjs.jcvjs_78_23. Epub 2023 Sep 18.ABSTRACTBACKGROUND: Lateral lumbar interbody fusions (LLIFs) utilize a retroperitoneal approach that avoids the intraperitoneal organs and manipulation of the anterior vasculature encountered in anterior approaches to the lumbar spine. The approach was championed by spinal surgeons; however, general/vasculature surgeons may be more comfortable with,

J Craniovertebr Junction Spine. 2023 Jul-Sep;14(3):281-287. doi: 10.4103/jcvjs.jcvjs_78_23. Epub 2023 Sep 18.

ABSTRACT

BACKGROUND: Lateral lumbar interbody fusions (LLIFs) utilize a retroperitoneal approach that avoids the intraperitoneal organs and manipulation of the anterior vasculature encountered in anterior approaches to the lumbar spine. The approach was championed by spinal surgeons; however, general/vasculature surgeons may be more comfortable with the approach.

OBJECTIVE: The objective of this study was to compare short-term outcomes following LLIF procedures based on whether a spine surgeon or access surgeon performed the approach.

MATERIALS AND METHODS: We retrospectively identified all one- to two-level LLIFs at a tertiary care center from 2011 to 2021 for degenerative spine disease. Patients were divided into groups based on whether a spine surgeon or general surgeon performed the surgical approach. The electronic medical record was reviewed for hospital readmissions and complication rates.

RESULTS: We identified 239 patients; of which 177 had approaches performed by spine surgeons and 62 by general surgeons. The spine surgeon group had fewer levels with posterior instrumentation (1.40 vs. 2.00; P < 0.001) and decompressed (0.94 vs. 1.25, P = 0.046); however, the two groups had a similar amount of two-level LLIFs (29.9% vs. 27.4%, P = 0.831). This spine surgeon approach group was found to have shorter surgeries (281 vs. 328 min, P = 0.002) and shorter hospital stays Length of Stay (LOS) (3.1 vs. 3.6 days, P = 0.019); however, these differences were largely attributed to the shorter posterior fusion construct. On regression analysis, there was no statistical difference in postoperative complication rates whether or not an access surgeon was utilized (P = 0.226).

: Similar outcomes may be seen regardless of whether a spine or access surgeon performs the approach for an LLIF.

PMID:37860021 | PMC:PMC10583800 | DOI:10.4103/jcvjs.jcvjs_78_23

The London Spine Unit : innovative treatment clinic on Harley Street UK

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Lateral approach to the lumbar spine: The utility of an access surgeon

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J Craniovertebr Junction Spine. 2023 Jul-Sep;14(3):281-287. doi: 10.4103/jcvjs.jcvjs_78_23. Epub 2023 Sep 18.ABSTRACTBACKGROUND: Lateral lumbar interbody fusions (LLIFs) utilize a retroperitoneal approach that avoids the intraperitoneal organs and manipulation of the anterior vasculature encountered in anterior approaches to the lumbar spine. The approach was championed by spinal surgeons; however, general/vasculature surgeons may be more comfortable with

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