J Korean Orthop Assoc.  2019 Jun;54(3):203-210. 10.4055/jkoa.2019.54.3.203.

Minimally Invasive Lateral Lumbar Interbody Fusion: Indications, Outcomes and Complications

• Soh J
• Lee JC

• KMID: 2450139
• DOI: http://doi.org/10.4055/jkoa.2019.54.3.203

Abstract

The aim of this review was to evaluate minimally invasive lateral lumbar interbody fusion on the latest update. Lumbar interbody fusion was introduced recently. This study performed, a literature review of the indications, clinical outcomes, fusion rate, and complications regarding recently highlighted minimally invasive lateral lumbar interbody fusion. The indications of lateral lumbar interbody fusion are similar to the conventional anterior and posterior interbody fusion in degenerative lumbar diseases. In particular, lateral lumbar interbody fusion is an effective minimally invasive surgery in spinal stenosis, degenerative spondylolisthesis, degenerative adult deformity, degenerative disc disease and adjacent segment disease. In addition, the clinical outcomes and fusion rates of lateral lumbar interbody fusion are similar compared to conventional lumbar fusion. On the other hand, non-specific complications including hip flexor weakness, nerve injury, vascular injury, visceral injury, cage subsidence and pseudohernia have been reported. Lateral lumbar interbody fusion is a very useful minimally invasive surgery because it has advantages over conventional anterior and posterior interbody fusion without many of the disadvantages. Nevertheless, nonspecific complications during lateral lumbar interbody fusion procedure remain a challenge to be improved.

Keyword

lumbar; degenerative lumbar disease; lateral lumbar interbody fusion

MeSH Terms

Adult
Congenital Abnormalities
Hand
Hip
Humans
Minimally Invasive Surgical Procedures
Spinal Stenosis
Spondylolisthesis
Vascular System Injuries

Figure

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  Figure 1. (A) Preoperative T2-weighted magnetic resonance (MR) sagittal image shows spinal foraminal stenosis due to a narrowing of the disc height on L3–4 (arrow). (B) Preoperative T2-weighted MR sagittal image shows spinal central stenosis due to hypertrophy of ligament flavum on L3–4 (arrow). (C) After lateral lumbar interbody fusion and posterior percutaneous screw fixation, the T2-weighted MR sagittal image shows widening of foramen due to restoration of disc height on L3–4 (arrow). This shows indirect foraminal decompression. (D) After lateral lumbar interbody fusion and posterior percutaneous screw fixation, the T2-weighted MR sagittal image shows widening of the neural canal due to distraction of ligament flavum on L3–4 (arrow). This shows indirect central decompression.

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  Figure 2. (A) Preoperative and postoperative whole spine anterolateral standing plain X-rays show degenerative scoliosis on lumbar spine was corrected. (B) Preoperative and postoperative whole spine lateral standing plain X-rays show that the degenerative kyphosis on lumbar spine had been corrected. LL, lumbar lordosis; SS, sacral slope; PT, pelvic tilt.

Reference

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