19 Harley St, London, W1G 9QJ, UK

Laterally Placed Expandable Interbody Spacers With and Without Adjustable Lordosis Improve Radiographic and Clinical Outcomes: A Two-Year Follow-Up Study Research Article

The London Spine Unit : best rated day surgery spinal centre in the world

Published article

Introduction Interbody spacers are necessary for achieving disc height restoration when surgical intervention is used for the treatment of severe degenerative disc disease. Minimally invasive lateral lumbar interbody fusion (MIS LLIF) is a popular surgical approach that historically uses large static interbody spacers through a lateral approach. However, static spacers have been associated with iatrogenic distraction and excessive impaction forces, which may increase the risk of subsidence and…
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK

Cureus. 2021 Dec 9;13(12):e20302. doi: 10.7759/cureus.20302. eCollection 2021 Dec.

ABSTRACT

Introduction Interbody spacers are necessary for achieving disc height restoration when surgical intervention is used for the treatment of severe degenerative disc disease. Minimally invasive lateral lumbar interbody fusion (MIS LLIF) is a popular surgical approach that historically uses large static interbody spacers through a lateral approach. However, static spacers have been associated with iatrogenic distraction and excessive impaction forces, which may increase the risk of subsidence and loss of lordosis, compromising stability. Expandable interbody spacers with or without adjustable lordosis may help address these concerns by maximizing segmental lordosis and aiding in sagittal balance correction. This study describes the clinical and radiographic outcomes of patients treated with expandable interbody spacers with or without adjustable lordosis, for MIS LLIF. Materials and methods This is retrospective, single-surgeon Institutional Review Board-exempt chart review was of 103 consecutive patients who had undergone MIS LLIF at one to two contiguous level(s) utilizing expandable interbody spacers with or without adjustable lordosis (66/103 patients had adjustable lordosis spacers). Collection of clinical and radiographic functional outcomes occurred at preoperative and postoperative time points through 24 months. Results One-hundred and three consecutive patients were evaluated-average age, 58.2 ± 12.1 years; 42.1% (45/107) were female. There were 78.6% (81/103) one-level cases and 21.4% (22/103) two-level cases for a total of 125 levels; 44.8% (56/125) were performed at L4-5 and 34.4% (43/125) at L3-4. The average estimated blood loss was 24.6 ± 12.3cc. Mean operative time was 61.0 ± 19.1 min, and mean fluoroscopic time was 28.2 ± 14.6 sec. Visual Analog Scale (VAS) back and leg pain scores decreased significantly by an average of 7.1 ± 1.0 points at 24 months (p<0.001). Oswestry Disability Index (ODI) scores significantly decreased by a mean of 67.4 ± 8.9 points at 24 months (p<0.001). Lumbar lordosis significantly improved by a mean of 3.1 ± 8.8° at 24 months (p=0.001). Anterior, middle, and posterior disc height significantly increased at 24 months by averages of 4.7 ± 3.1, 4.0 ± 3.0, and 2.1 ± 2.2mm, respectively (p<0.001). Neuroforaminal height had significantly increased at 24 months by a mean of 3.0 ± 3.6mm (p<0.001). Segmental lordosis significantly improved by 3.7 ± 2.9° at 24 months (p<0.001). There were 51 patients with abnormal preoperative Pelvic Incidence-Lumbar Lordosis (PI-LL) measurements that significantly improved by 9.1 ± 4.9° (p<0.001) and 52 patients with normal preoperative PI-LL measurements that improved by 0.2 ± 4.6° (p=0.748) at 24 months. One-hundred percent fusion occurred at all levels, and no findings of radiolucency were observed. One case of subsidence (1/125, 0.8%) was reported at 24 months. No implanted-related complications were reported, with 0% pseudoarthrosis and no secondary surgery required at the operative levels. Conclusion Indirect decompression and sagittal correction were achieved and maintained through a 24-month follow-up. Functional clinical outcomes significantly improved based on decreased VAS pain and ODI scores at 24 months. This study resulted in positive clinical and radiographic outcomes for patients who underwent MIS LLIF with expandable interbody spacers with or without adjustable lordosis.

PMID:35028207 | PMC:PMC8748004 | DOI:10.7759/cureus.20302

The London Spine Unit : best rated day surgery spinal centre in the world

Read the original publication:

Laterally Placed Expandable Interbody Spacers With and Without Adjustable Lordosis Improve Radiographic and Clinical Outcomes: A Two-Year Follow-Up Study

Truspilot Reviews

shahnaz Choudhury
shahnaz Choudhury
2022-04-22
I had a massive bulging disk on my back… I had a massive bulging disk on my back compressing my nerve for three years. It caused me excruciating pain and almost left me disabled. I was on both crutches and completely homebound due to the severity of pain and mobility limitations. I had my lumber surgery two weeks ago and walked out of hospital within a few hours pain free on my right leg that was almost paralysing prior to surgery. The disk was shaved off releasing the nerve completely. Two days after surgery I had excruciating pain on my head that is unexplained as I had CT scan and MRI which were all fine. Dr Akmal has suggested it could be from the anaesthetic. I am extremely grateful to Dr Akmal and his very welcoming and cari g team. I would highly recommend his clinic as I have had excellent recovery.
MR HARVEY
MR HARVEY
2022-04-02
Thank you Mr Aklam After having a poor and very slow experiance in glasgow . I contacted Mr mo Amlam . Who is a true gentleman, great listener and paitent . We transfered my scans and treatments from glasgow to harley street . Mr Aklams p.a arranged a quick zoom to start our contact .I then went down for a meeting and examination and what should have been a spec scan .only to be told of a UK shortage . So 4 weeks later the scan took place in wellington hospital . Before I traveled back to glasgow. 5 days later I got a call to book me in to 19 harley street for a l3 and l4 debridement and stabilisation. The opp took place on 24th March. 2hours I was out walking 4 hours later . My pain in back groin and foot was all gone .thanks to Mr aklam . Top of his craft but more importantly pouts his patients first .he really wants to help you get better. Thank you so much Mr Robert harvey
Ken Carswell
Ken Carswell
2022-03-22
Amazing service and an amazing treatment! I can't thank Mr Akmal and team at the London Spine Unit enough for their help. I had a herniated disc in my back which was causing pain and restrictions. Compared to other offers of surgery (e.g. several nights in hospital), the day surgery and minimally invasive procedure were hugely appealing. I am now 3 weeks post surgery, have no pain and am recovering incredibly quickly if I compare myself to friends who have had a similar procedure. it was truly remarkable, straightforward and the team were kind, friendly and always helpful. very highly recommended!
customer
customer
2022-03-17
Great service and painless procedure Great service and painless procedure. Definitely alleviated the pain
Jonathan Scott-Barrett
Jonathan Scott-Barrett
2022-02-09
Back and nerve pain From diagnosis to treatment and post operational care, the London Spine Unit were very courteous, caring, efficient and generally first class in all departments of their clinic. My ailments pre operation have been successfully eradicated and I no longer suffer from back and nerve pain. I can also walk without stooping. I would not hesitate to recommend anyone with back problems to seek their advice and treatment if required. 9th February 2022
Kelly Tyler
Kelly Tyler
2022-01-29
Very good service and quality care Very good service and quality care. The help is invaluable.
Amanda Main
Amanda Main
2022-01-25
Very good service and attention Very good service and attention. The doctors are very kind, they attend with care and always report the condition well. The times that I have been able to visit them, there are not many, I have left very happy because they have relieved my back pain.
Arvind Manjit Singh
Arvind Manjit Singh
2022-01-15
My interaction with Ms Rola Shamlakh… My interaction with Ms Rola Shamlakh was v educative. The way she explained the logic behind the basic exercises she taught me has really helped me to internalise those. Nobody I had consulted for years ( I suffer from arthritis of knees) had done like her before. She was wonderful. Overall it was a v fruitful session. I wish I cud have more such sessions with her but had to return to my country. But hope to be back soon to consult her more…..
thomas may
thomas may
2022-01-06
In early 2021 my back pain which had… In early 2021 my back pain which had long troubled me became acute and it became clear that I urgently needed help .A friend whose father had been similarly afflicted recommended Mo Akmal of the London Spine unit to help me . After a 'phone consultation he immediately summoned me to London for an MRI which resulted in immediate surgery . His very professional team which included a very able assistant , Dr. Lok , operated and in short order , having been crippled ,in great pain and almost unable to walk , I emerged from the procedure pain free . I am aware that this was a very intricate and delicate procedure which had been fully explained to me from the outset. Full supervised recovery took place over the ensuing six months and I am now very physically active and able to take part in all the things that had been previously impossible.
Jag Sandhu
Jag Sandhu
2022-01-05
Spinal fractures and balloon kyphoplasty procedure Due to oesterprosis last year I ended up with 8 spinal fractures, as the NHS failed to investigate my back pain, I had no choice but to refer myself to a private consultation at the Harley St spinal Clinic. I was under Dr Mo Akmal who arranged Mris and from here he found out I had 8 fractures, he suggested a procedure called balloon kyphoplasty, this was done in October 2021. The procedure itself went well and the care Harley st and Dr Akmals team gave me was exceptionall. Dr Akmal is one of the best surgeon s we read his reviews on Trust pilot before we made the initial appointment, he is a very kind and caring person who is professional as well as genuinely caring about you and your health problems. Its 3 months after my surgery and I am not taking any painkillers, I still have a little way to go as healing can take a few months but I'm hopeful my back will be back to as normal as it can be.. I am still under review under Dr Akmal so this gives me reassurance that until I'm not fully fixed he will be looking after me.

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile

 

What our patients say ...

Cureus. 2021 Dec 9;13(12):e20302. doi: 10.7759/cureus.20302. eCollection 2021 Dec.ABSTRACTIntroduction Interbody spacers are necessary for achieving disc height restoration when surgical intervention is used for the treatment of severe degenerative disc disease. Minimally invasive lateral lumbar interbody fusion (MIS LLIF) is a popular surgical approach that historically uses large static interbody spacers through a lateral approach.…

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£1130
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD
Popular

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