A new study in the Journal of Neurosurgery: Spine examines the effectiveness of extreme lateral interbody fusion.
The study includes 90 patients with degenerative disorders and 145 treated levels. Seventy-seven percent of the patients received pedicle screw and rod constructs. Lateral plates were used to stabilize fixation in 13 percent of the cases. In 10 percent of the cases, standalone cages were used.
Here are six findings from the study:
• Around one year after surgery, the coronal Cobb angle was 10.6 degrees on the radiological follow-up, an improvement from 23.8 degrees preoperatively on average.
• Lumbar sagittal lordosis increased 5.3 degrees postoperatively and by 2.9 degrees at the latest follow-up.
• Foraminal height increased 4 mm and disc height increased 3.3 mm immediately after surgery and the improvements remained through the last follow-up.
• The patients reported ODI improvement by 21 percent and VAS scores improved at 17.6 months postoperatively.
• The Macnab criteria revealed 84.8 percent of patients had excellent, good or fair functional outcomes.
• Only 4.4 percent of patients reported new postoperative thigh numbness; weakness was detected in 2.2 percent of the patients. However, both were resolved within the first three months postoperatively in all but one case.
This study is among the most comprehensive set of radiological and clinical outcomes for extreme lateral interbody fusion in a large population at midterm follow-up. It showed the procedure has good clinical outcomes and a low complication rate.
"The procedure allows for at least midterm clinically effective restoration of disc and foraminal heights," concluded the study authors. "Improvement in coronal deformity and small but significant increase in sagittal lordosis were observed."
However, the authors also noted there wasn't significant improvement in the PI-LL mismatch in scoliotic patients.
A separate study presented at the Society for Minimally Invasive Spine Surgery in 2011 examined 107 patients who underwent XLIF with and without supplemental treatment for degenerative scoliosis. Two years after surgery, 85 percent of patients were satisfied with their procedure and 85 percent said they would have that procedure again. There were major complications in 13 patients, including one posterior revision for painful hardware and one cage failure without revision.
As a result, the authors concluded XLIF is a "valuable adjunct in the treatment of adult scoliosis."
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