Low Revision Rate Associated With Lateral Lumbar Interbody Fusion

Stand-alone lateral lumbar interbody fusion is an acceptable arthrodesis option for patients with spinal stenosis with instability or degenerative scoliosis, researchers from two center found in a study.

“Lateral lumbar interbody fusion (LLIF) is an alternative, minimally invasive approach to the lumbar spine for degenerative conditions. It involves approaching the lumbar spine through a psoas-splitting retroperitoneal approach, while taking care to preserve and protect the lumbar plexus with minimal risk to these structures,” Venu M. Nemani, M.D., Ph.D., and colleagues wrote in their study published in Spine. “LLIF offers several advantages compared with anterior approaches to interbody fusion including preservation of the anterior longitudinal ligament, the ability to seat the implant on dense apophyseal bone rather than on cancellous bone, and decreased risk of injury to the great vessels.”

Nemani and colleagues analyzed the results of 117 patients who underwent stand-alone LLIF for symptomatic spinal stenosis and focused on those who required revision surgery for persistent symptoms. Of the 83 women and 34 men in the study, the average age was 63.6 years (range 30 years to 87 years) and the average follow up time was 15.6 months.

Twelve of the 117 patients (10.3 percent) required a revision for persistent symptoms, the researchers noted.

“For the majority of patients, a stand-alone procedure was sufficient to restore disc height and indirectly decompress the neural elements resulting in improvement in symptoms. The revision rate for a formal posterior decompression or posterolateral fusion after a stand-alone procedure was 10.3 percent at an average follow-up of 1.3 years, making stand-alone LLIF a reasonable option for patients with stenosis and an indication for fusion at the affected levels,” Nemani and colleagues wrote in the study.