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P Guigui, E Ferrero
Degenerative spondylolisthesis is a common pathology, often causing lumbar canal stenosis. There is, however, no strong consensus regarding the various medical and surgical treatments available. Surgery is indicated mainly for perceived functional impairment; when the indication is accepted, several questions determine the choice of surgical strategy. Improvement in neurological symptoms is one of the main treatment objectives. For this, it is useful to perform radicular decompression. Some authors recommend indirect decompression by interbody fusion (ALIF, TLIF, XLIF), others by means of an interspinous spacer but the most frequent technique is direct posterior decompression...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Qiyou Wang, Yichun Xu, Ruiqiang Chen, Jianwen Dong, Bin Liu, Limin Rong
RATIONALE: To describe a novel indication for a method through minimally invasive extreme lateral interbody fusion (XLIF) in combination with percutaneous pedicle screwsfixation in the treatment of lumbar tuberculosis (TB) in an elderly patient, and its clinical efficacy and feasibility. Lumbar TB is a destructive form of TB. Antituberculous treatment should be started as early as possible. In some circumstances, however, surgical debridement with or without stabilization of the spine appears to be beneficial and may be recommended...
November 2016: Medicine (Baltimore)
Timothy L T Siu, Elmira Najafi, Kainu Lin
Direct Lumbar Interbody Fusion (DLIF) and eXtreme Lateral Interbody Fusion (XLIF) are the most common surgical platforms available for performing transpsoas spinal fusion but no study has been carried out to compare them. We evaluated 21 DLIF and 22 XLIF cage positions by measuring the distance between the posterior vertebral border and the centre of the cage normalised to the midsagittal length of the inferior end plate. We found that DLIF cages were significantly more anteriorly located than XLIF (0.65 vs 0...
March 2017: Journal of Orthopaedics
Enrico Tessitore, Ilaria Melloni, Oliver P Gautschi, Gianluigi Zona, Karl Schaller, Pedro Berjano
BACKGROUND: Sagittal balance is widely recognized as an important outcome factor in reconstructive spinal surgery for lumbar degenerative conditions. However, its role in short segmental fixation is unknown. The aim of this study is to evaluate the preoperative and short-term postoperative spino-pelvic balance after short (1 or 2 levels) lordosizing lumbar fusion for degenerative disc disease (DDD). MATERIALS AND METHODS: Twenty-six consecutive patients (13 males and 13 females) undergoing mono- or bisegmental lordosizing lumbar fusion (XLIF/TLIF) for lumbar DDD were included in the study...
November 17, 2016: Journal of Neurosurgical Sciences
Nancy E Epstein
BACKGROUND: Major factors prompted the development of minimally invasive (MIS) extreme lateral interbody fusion (XLIF; NuVasive Inc., San Diego, CA, USE) for the thoracic/lumbar spine. These include providing interbody stabilization and indirect neural decompression while avoiding major visceral/vessel injury as seen with anterior lumbar interbody fusion (ALIF), and to avert trauma to paraspinal muscles/facet joints found with transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF), and posterior-lateral fusion techniques (PLF)...
2016: Surgical Neurology International
Nancy E Epstein
BACKGROUND: Complications exclusive of new neurological deficits/injuries that follow extreme lateral interbody fusion (XLIF) and related lateral lumbar interbody techniques should be better recognized to determine the safety of these procedures. Unfortunately, a review of the XLIF literature did not accurately reflect the frequency of these "other complications" as few US surgeons publish such adverse events that may lead to medicolegal suits. METHODS: Major complications occurring with XLIF included sympathectomy, major vascular injuries, bowel perforations, sterile seromas, and instrumentation failures...
2016: Surgical Neurology International
Nancy E Epstein
BACKGROUND: There are frequent reports of lumbosacral plexus and other neurological injuries occurring with extreme lateral interbody fusions (XLIF) and other related lateral lumbar techniques. METHODS: This review focuses on the new neurological deficits (e.g. lumbosacral plexus, root injuries) that occur following minimally invasive surgery (MIS) XLIF and other related lateral lumbar techniques. RESULTS: A review of multiple articles revealed the following ranges of new postoperative neurological complications for XLIF procedures: plexus injuries 13...
2016: Surgical Neurology International
Kotaro Satake, Tokumi Kanemura, Hidetoshi Yamaguchi, Naoki Segi, Jun Ouchida
STUDY DESIGN: Retrospective study. PURPOSE: To compare intraoperative endplate injury cases and no injury cases in consecutive series and to identify predisposing factors for intraoperative endplate injury. OVERVIEW OF LITERATURE: Unintended endplate violation and subsequent cage subsidence is an intraoperative complication of extreme lateral interbody fusion (XLIF). It is still unknown whether it is derived from inexperienced surgical technique or patients' inherent problems...
October 2016: Asian Spine Journal
Enrico Tessitore, Granit Molliqaj, Karl Schaller, Oliver Pascal Gautschi
Extreme lateral interbody fusion (XLIF) is an alternative to standard posterior approaches for achieving fusion in the lumbar spine. It allows exposure of the lateral aspect of the lumbar disc through a lateral approach with the possibility to insert a wide footprint interbody cage as a stand-alone procedure or associated with a uni- or bilateral percutaneous fixation. This is a retrospective series of 20 consecutive patients operated with a XLIF procedure from 2014 to 2015. N=10 women and N=10 men with a mean age of 67...
February 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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...
January 2017: 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: Journal of Spine Surgery (Hong Kong)
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
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