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Unique Characteristics of New Bone Formation Induced by Lateral Lumbar Interbody Fusion Procedure – Lumbar Fusion

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The article explores the incidence and associated factors of lateral bridging callus (LBC) formation following extreme lateral interbody fusion (XLIF) surgery. The study enrolled 136 patients who underwent lumbar fusion surgery using XLIF, and one year postoperatively, the L4/5 segments were divided into LBC formation and non-formation groups. The incidence of LBC formation was found to be 58.8%. The study identified the length of osteophytes as a significant predictive factor for LBC formation. The results suggest that LBC formation is common after XLIF surgery and is associated with the length of osteophytes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced spine hospital in UK

Published article

S: The incidence of LBC formation was 58.8% in L4/5 levels one year after the XLIF procedure. We demonstrated that the length of the osteophyte was significantly associated with LBC formation.

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Spine Surg Relat Res. 2023 Jun 9;7(5):450-457. doi: 10.22603/ssrr.2022-0108. eCollection 2023 Sep 27.ABSTRACTINTRODUCTION: Despite the absence of bone grafting in the area outside the cage, lateral bridging callus outside cages (LBC) formation is often observed here following extreme lateral interbody fusion (XLIF) conversely to conventional methods of transforaminal lumbar interbody fusion and posterior lumbar interbody,

Spine Surg Relat Res. 2023 Jun 9;7(5):450-457. doi: 10.22603/ssrr.2022-0108. eCollection 2023 Sep 27.

ABSTRACT

INTRODUCTION: Despite the absence of bone grafting in the area outside the cage, lateral bridging callus outside cages (LBC) formation is often observed here following extreme lateral interbody fusion (XLIF) conversely to conventional methods of transforaminal lumbar interbody fusion and posterior lumbar interbody fusion. The LBC, which may increase stabilization and decrease nonunion rate in treated segments, has rarely been described. This study aimed to identify the incidence and associated factors of LBC following XLIF.

METHODS: We enrolled 136 consecutive patients [56 males, 80 females; mean age 69.6 (42-85) years] who underwent lumbar fusion surgery using XLIF, including L4/5 level with posterior fixation at a single institution between February 2013 and February 2018. One year postoperatively, the treated L4/5 segments were divided into the LBC formation and non-formation groups. Potential influential factors, such as age, sex, body mass index, bone density, height of cages, cage material (titanium or polyetheretherketone [PEEK]), presence or absence of diffuse idiopathic skeletal hyperostosis (DISH), and radiological parameters, were evaluated. Multivariate logistic regression analysis was performed for factors significantly different from the univariate analysis.

RESULTS: The incidence of LBC formation was 58.8%. Multivariate logistic regression analysis showed that the length of osteophytes [+1 mm; odds ratio, 1.29; 95% confidence interval, 1.17-1.45; p<0.0001] was significant LBC formation predictive factors. Receiver operating characteristic curve analysis demonstrated that the cut-off value for osteophyte length was 14 mm, the sensitivity was 58.8%, the specificity was 84.4%, and the area under the ROC curve for this model was 0.79.

S: The incidence of LBC formation was 58.8% in L4/5 levels one year after the XLIF procedure. We demonstrated that the length of the osteophyte was significantly associated with LBC formation.

PMID:37841039 | PMC:PMC10569808 | DOI:10.22603/ssrr.2022-0108

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Unique Characteristics of New Bone Formation Induced by Lateral Lumbar Interbody Fusion Procedure

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Spine Surg Relat Res. 2023 Jun 9;7(5):450-457. doi: 10.22603/ssrr.2022-0108. eCollection 2023 Sep 27.ABSTRACTINTRODUCTION: Despite the absence of bone grafting in the area outside the cage, lateral bridging callus outside cages (LBC) formation is often observed here following extreme lateral interbody fusion (XLIF) conversely to conventional methods of transforaminal lumbar interbody fusion and posterior lumbar interbody
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