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Lateral lumbar interbody fusion at L4-L5 has a low rate of complications in appropriately selected patients when using a standardized surgical technique – Lumbar Fusion

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The article presents a multicenter retrospective study that aimed to reassess the rate of complications associated with L4-L5 lateral lumbar interbody fusion (LLIF), a surgical procedure used for spinal fusion. The study involved 517 patients who underwent LLIF by seven surgeons at seven institutions in three countries over a five-year period. The results showed that the rate of neurological, psoas-related, and abdominal complications was relatively low, with femoral neuropraxia occurring in 1.2% of patients and non-femoral neuropraxia in 1.8% of patients. Thigh pain, weakness of hip flexion, and other complications were also recorded, although the rates were generally low. The study concludes that LLIF, when performed with appropriate indications and standardized surgical techniques, has a low rate of persistent complications at the L4-L5 disc level

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: LLIF involving the L4-L5 disc level has a low rate of persistent neurological, psoas-related, and abdominal complications in patients with the appropriate indications and using a standardized surgical technique.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Bone Joint J. 2024 Jan 1;106-B(1):53-61. doi: 10.1302/0301-620X.106B1.BJJ-2023-0693.R2.ABSTRACTAIMS: The aim of this study was to reassess the rate of neurological, psoas-related, and abdominal complications associated with L4-L5 lateral lumbar interbody fusion (LLIF) undertaken using a standardized preoperative assessment and surgical technique.METHODS: This was a multicentre retrospective study involving consecutively enrolled patients who underwent L4-L5 LLIF,

Bone Joint J. 2024 Jan 1;106-B(1):53-61. doi: 10.1302/0301-620X.106B1.BJJ-2023-0693.R2.

ABSTRACT

AIMS: The aim of this study was to reassess the rate of neurological, psoas-related, and abdominal complications associated with L4-L5 lateral lumbar interbody fusion (LLIF) undertaken using a standardized preoperative assessment and surgical technique.

METHODS: This was a multicentre retrospective study involving consecutively enrolled patients who underwent L4-L5 LLIF by seven surgeons at seven institutions in three countries over a five-year period. The demographic details of the patients and the details of the surgery, reoperations and complications, including femoral and non-femoral neuropraxia, thigh pain, weakness of hip flexion, and abdominal complications, were analyzed. Neurological and psoas-related complications attributed to LLIF or posterior instrumentation and persistent symptoms were recorded at one year postoperatively.

RESULTS: A total of 517 patients were included in the study. Their mean age was 65.0 years (SD 10.3) and their mean BMI was 29.2 kg/m2 (SD 5.5). A mean of 1.2 levels (SD 0.6) were fused with LLIF, and a mean of 1.6 (SD 0.9) posterior levels were fused. Femoral neuropraxia occurred in six patients (1.2%), of which four (0.8%) were LLIF-related and two (0.4%) had persistent symptoms one year postoperatively. Non-femoral neuropraxia occurred in nine patients (1.8%), one (0.2%) was LLIF-related and five (1.0%) were persistent at one year. All LLIF-related neuropraxias resolved by one year. A total of 32 patients (6.2%) had thigh pain, 31 (6.0%) were LLIF-related and three (0.6%) were persistent at one year. Weakness of hip flexion occurred in 14 patients (2.7%), of which eight (1.6%) were LLIF-related and three (0.6%) were persistent at one year. No patients had bowel injury, three (0.6%) had an intraoperative vascular injury (not LLIF-related), and five (1.0%) had ileus. Reoperations occurred in five patients (1.0%) within 30 days, 37 (7.2%) within 90 days, and 41 (7.9%) within one year postoperatively.

: LLIF involving the L4-L5 disc level has a low rate of persistent neurological, psoas-related, and abdominal complications in patients with the appropriate indications and using a standardized surgical technique.

PMID:38164083 | DOI:10.1302/0301-620X.106B1.BJJ-2023-0693.R2

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Lateral lumbar interbody fusion at L4-L5 has a low rate of complications in appropriately selected patients when using a standardized surgical technique

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Bone Joint J. 2024 Jan 1;106-B(1):53-61. doi: 10.1302/0301-620X.106B1.BJJ-2023-0693.R2.ABSTRACTAIMS: The aim of this study was to reassess the rate of neurological, psoas-related, and abdominal complications associated with L4-L5 lateral lumbar interbody fusion (LLIF) undertaken using a standardized preoperative assessment and surgical technique.METHODS: This was a multicentre retrospective study involving consecutively enrolled patients who underwent L4-L5 LLIF
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