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Erlick A C Pereira, Mohammad Farwana, Khai S Lam
Spinal stenosis and low-grade spondylolisthesis produce symptoms of neural compression that can be treated with extreme lateral lumbar interbody fusion (XLIF) via indirect decompression. This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Mark J Winder, Shanu Gambhir
The incidence of lumbar fusion for the treatment of various degenerative lumbar spine diseases has increased dramatically over the last twenty years. Many lumbar fusion techniques have been developed and popularized, each with its own advantages and disadvantages. Anterior lumbar interbody fusion (ALIF) initially introduced in the 1930's, has become a common and widely accepted technique for lumbar fusions over the last decade offering several advantages over standard posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF)...
March 2016: J Spine Surg
Sohrab S Virk, Elizabeth Yu
STUDY DESIGN: Bibliometric study of current literature OBJECTIVE.: To catalog the most important minimally invasive spine (MIS) surgery articles using the amount of citations as a marker of relevance. SUMMARY OF BACKGROUND DATA: MIS surgery is a relatively new tool used by spinal surgeons. There is a dynamic and evolving field of research related to MIS techniques, clinical outcomes and basic science research. To date, there is no comprehensive review of the most cited articles related to MIS surgery...
July 19, 2016: Spine
Naoki Notani, Masashi Miyazaki, Toyomi Yoshiiwa, Toshinobu Ishihara, Hiroshi Tsumura
PURPOSE: To describe the first case of a patient who developed acute celiac artery compression syndrome (ACACS) after extensive correction of sagittal balance on an adult spinal deformity. METHODS: A 77-year-old woman presented with low back pain and spinal kyphosis deformity. We performed a two-stage correction with extreme lateral interbody fusion (XLIF), and her lumbar lordosis improved from -47° to 53°. However, after surgery, she experienced frequent vomiting and diarrhea...
June 23, 2016: European Spine Journal
Carlo Mandelli, Elena Virginia Colombo, Giovanni Marco Sicuri, Pietro Mortini
PURPOSE: XLIF (®) is a widely used minimally invasive technique to treat different spine pathologies. The aim of this study was to quantify nerve distortion of lumbar plexus during XLIF (®) approach and to correlate it with morphometric data. METHODS: Nine fresh frozen cadaveric specimens were used. All specimens were subjected to the same dissection procedure cored on a left XLIF® approach at L2/L3 and L4/L5 levels. Distortion of cutaneous superficial nerves, femoral nerve (FN) at L4/L5 and genitofemoral nerve (GN) at L2/L3 and L4/L5 while opening the retractor were assessed and analyzed with respect to psoas muscle features...
May 24, 2016: European Spine Journal
Wataru Narita, Ryota Takatori, Yuji Arai, Masateru Nagae, Hitoshi Tonomura, Tatsuro Hayashida, Taku Ogura, Hiroyoshi Fujiwara, Toshikazu Kubo
OBJECTIVE Extreme lateral interbody fusion (XLIF) is a minimally disruptive surgical procedure that uses a lateral approach. There is, however, concern about the development of neurological complications when this approach is used, particularly at the L4-5 level. The authors performed a prospective study of the effects of a new neural monitoring system using a finger electrode to prevent neurological complications in patients treated with XLIF and compared the results to results obtained in historical controls...
May 20, 2016: Journal of Neurosurgery. Spine
Mauricio J Avila, Christina M Walter, Ali A Baaj
INTRODUCTION: Minimally invasive spine (MIS) surgery is gaining popularity in the elderly. With aging population and a strong desire for all patients to remain physically active, this trend will likely continue. Previous studies have reported clinical outcomes in the elderly undergoing MIS surgery; however, most of these studies encompass multiple surgeons at different sites and thus present heterogeneous experiences. In this work, we investigate the clinical outcomes and complications of all lumbar MIS procedures performed in patients over 65 years of age by a single surgeon...
2016: Curēus
Bennett D Grimm, Daniel P Leas, Steven C Poletti, Donald R Johnson
STUDY DESIGN: Retrospective chart review. OBJECTIVE: To determine complications within the first year after undergoing extreme lateral interbody fusion (XLIF). SUMMARY OF BACKGROUND DATA: There are a growing but limited number of reports in the literature regarding early postoperative complications after XLIF. METHODS: We performed a retrospective chart review of perioperative complications of a case series of the first 108 patients to undergo XLIF at our institution between 2007 and 2009...
April 2016: Clinical Spine Surgery
Nancy E Epstein
BACKGROUND: In a recent study entitled: "More nerve root injuries occur with minimally invasive lumbar surgery, especially extreme lateral interbody fusion (XLIF): A review", Epstein documented that more nerve root injuries occurred utilizing minimally invasive surgery (MIS) versus open lumbar surgery for diskectomy, decompression of stenosis (laminectomy), and/or fusion for instability. METHODS: In large multicenter Spine Patient Outcomes Research Trial reviews performed by Desai et al...
2016: Surgical Neurology International
Nancy E Epstein
BACKGROUND: In the lumbar spine, do more nerve root injuries occur utilizing minimally invasive surgery (MIS) techniques versus open lumbar procedures? To answer this question, we compared the frequency of nerve root injuries for multiple open versus MIS operations including diskectomy, laminectomy with/without fusion addressing degenerative disc disease, stenosis, and/or degenerative spondylolisthesis. METHODS: Several of Desai et al. large Spine Patient Outcomes Research Trial studies showed the frequency for nerve root injury following an open diskectomy ranged from 0...
2016: Surgical Neurology International
William D Smith, Richard N W Wohns, Ginger Christian, Evelyn J Rodgers, W Blake Rodgers
STUDY DESIGN: Retrospective review of data from a prospective patient outcomes registry. OBJECTIVE: The object of this work was to examine patient and surgical predictors of early postoperative discharge and test the predictive model against two clinical series of outpatient minimally invasive lumbar fusion patients. SUMMARY OF BACKGROUND DATA: Outpatient and ambulatory surgery centers are regularly utilized for procedures with low-risk profiles and minimal need for extended postoperative observation, but little has been reported in lumbar spinal fusion producers...
April 2016: Spine
Robert E Isaacs, Jonathan N Sembrano, Antoine G Tohmeh
STUDY DESIGN: Prospective, multicenter, institutional review board approved study with randomized and observational study arms. OBJECTIVE: The purpose of this study was to compare radiographic outcomes between minimally invasive transforaminal (MIS TLIF) or MIS lateral interbody fusion (XLIF) in the treatment of patients with low-grade degenerative spondylolisthesis with stenosis through 2-year postoperative. SUMMARY OF BACKGROUND DATA: Few reports exist comparing different MIS approaches directly in the treatment of similar pathology, as most studies report differences between MIS and open procedures...
April 2016: Spine
Yoichiro Takata, Toshinori Sakai, Fumitake Tezuka, Kazuta Yamashita, Mitsunobu Abe, Kosaku Higashino, Akihiro Ngamachi, Koichi Sairyo
STUDY DESIGN: A retrospective study using 27 contrast-enhanced multi-planar computed tomography scans of subjects with lumbar scoliosis. OBJECTIVE: To assess the risk of injury of lumbar segmental arteries during transpsoas approach in patients with lumbar scoliosis. SUMMARY OF BACKGROUND DATA: Although lumbar interbody fusion using big intervertebral cage through transpsoas approach has a big advantage to correct coronal and sagittal deformity in patients with spinal deformity, the risk for injury of lumbar segmental artery is always concerned...
May 2016: Spine
Jing-Chuan Sun, Ji-Rong Wang, Ting Luo, Xian-Nan Jin, Rui Ma, Bei-Er Luo, Tao Xu, Yuan Wang, Hai-Bo Wang, Bin Zhang, Xiang Liu, Bing Zheng, Xu Peng, Yang Hou, Yong-Fei Guo, Guo-Hua Xu, Guo-Dong Shi, Jian-Gang Shi
STUDY DESIGN: Cadaveric study. OBJECTIVE: To provide anatomical basis for deciding the surgical approach and skin incision in thoracolumbar extreme lateral interbody fusion (XLIF) by delineating the attachment points of diaphragm. SUMMARY OF BACKGROUND DATA: Although the general anatomy of the thoracic diaphragm is well described, the specific attachment points of diaphragm concerned with the XLIF approach is yet to be elaborated. METHODS: Dissections were performed on 21 cases of formalin fixed specimens (12 males, 9 females, a total of 42 sets of data)...
February 2016: Spine
Hanneke I Berends, Henricus L Journée, Ilona Rácz, Jan van Loon, Roger Härtl, Maarten Spruit
PURPOSE: To optimize intraoperative neuromonitoring during extreme lateral interbody fusion (XLIF) by adding transcranial electrical stimulation with motor evoked potential (TESMEP) to previously described monitoring using spontaneous EMG (sEMG) and peripheral stimulation (triggered EMG: tEMG). METHODS: Twenty-three patients with degenerative lumbar scoliosis had XLIF procedures and were monitored using sEMG, tEMG and TESMEP. Spontaneous and triggered muscle activity, and the MEP of 5 ipsilateral leg muscles, 2 contralateral leg muscles and 1 arm muscle were monitored...
May 2016: European Spine Journal
Josip Buric
INTRODUCTION: Advanced intraoperative neuromonitoring (IONM) is used to attenuate postoperative complications and side effects of extreme lateral interbody fusion (XLIF). Specific factors relate to the presence of postoperative injury are not well understood. This study aims to identify intraoperative variables with correlations to new postoperative anterior thigh/groin sensory changes. METHODS: Twenty-nine patients with various degenerative lumbar conditions were treated with XLIF at a single institution...
2015: International Journal of Spine Surgery
Kevin Phan, Prashanth J Rao, Daniel B Scherman, Gordon Dandie, Ralph J Mobbs
We conducted a systematic review to assess the safety and clinical and radiological outcomes of the recently introduced, direct or extreme lateral lumbar interbody fusion (XLIF) approach for degenerative spinal deformity disorders. Open fusion and instrumentation has traditionally been the mainstay treatment. However, in recent years, there has been an increasing emphasis on minimally invasive fusion and instrumentation techniques, with the aim of minimizing surgical trauma and blood loss and reducing hospitalization...
November 2015: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Josip Buric, Domenico Bombardieri
PURPOSE: Description of a case of direct intraoperative lesion and repair of a major vascular injury of common iliac vein during an extreme lateral interbody fusion L4-L5 procedure. METHODS: A 69-year-old female who was operated for L4-L5 spondilolysthesis suffered a major vascular injury of a vein. The high cava bifurcation and inadequate pre-operative analysis of the radiological documentation resulted in the lesion. The lesion was successfully repaired and the patient did not suffer post-operative sequelae...
May 2016: European Spine Journal
Daniel J Blizzard, Christopher P Hills, Robert E Isaacs, Christopher R Brown
The purpose of this study was to evaluate our initial experience utilizing extreme lateral interbody fusion (XLIF; NuVasive, San Diego, CA, USA) with percutaneous posterior instrumentation to treat 11 spondylodiscitis patients between January 2011 and February 2014. Although medical management is the first line treatment for spondylodiscitis, many patients fail antibiotic therapy and bracing, or present with instability, neurologic deficits, or sepsis, requiring operative debridement and stabilization. High rates of fusion and infection clearance have been reported with anterior lumbar interbody fusion (ALIF), but this approach requires a morbid exposure, associated with non-trivial rates of vascular and peritoneal complications...
November 2015: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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