Asian Spine J.  2014 Aug;8(4):491-497. 10.4184/asj.2014.8.4.491.

Mini-Open Approach for Direct Lateral Lumbar Interbody Fusion

Affiliations
  • 1Spine Center, Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. csl@smc.samsung.co.kr
  • 2Department of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Abstract

STUDY DESIGN: Retrospective analysis. PURPOSES: To introduce the mini-open lateral approach for the anterior lumbar interbody fusion (ALIF), and to investigate the advantages, technical pitfalls and complications by providing basic knowledge on extreme lateral interbody fusion (XLIF) or direct lumbar interbody fusion (DLIF). OVERVIEW OF LITERATURE: Recently, minimally invasive lateral approach for the lumbar spine is revived and receiving popularity under the name of XLIF or DLIF by modification of mini-open method when using the sequential tubular dilator and special expandable retractor system.
METHODS
Seventy-four patients who underwent surgery by the mini-open lateral approach from September 2000 to April 2008 with various disease entities were included. Blood losses, operation times, incision sizes, postoperative time to mobilization, length of hospital stays, technical problems and complications were all analyzed.
RESULTS
The blood losses and operation times of patients who underwent simple ALIF were 61.2 mL and 86 minutes for one level, 107 mL and 106 minutes for two levels, 250 mL and 142.8 minutes for three levels, and 400 mL and 190 minutes for four levels of fusion. The incision sizes were on average 4.5 cm for one level, 6.3 cm for two levels, 8.5 cm for three levels and 10.0 cm for four levels of fusion. The complications were retroperitoneal hematoma (2 cases), pneumonia (1 case) and transient lumbosacral plexus palsy (3 cases).
CONCLUSIONS
Trials of mini-open lateral approach would be helpful before the trial of XLIF or DLIF. However, special attention is required for complications such as transient lumbosacral plexus palsy.

Keyword

Lumbar spine; Mini-open lateral approach; Interbody fusion

MeSH Terms

Hematoma
Humans
Length of Stay
Lumbosacral Plexus
Paralysis
Pneumonia
Retrospective Studies
Spine
Full Text Links
  • ASJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr