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Anterior Lumbar Interbody Fusion

Ahilan Sivaganesan, Brandon Hirsch, Frank M Phillips, Matthew J McGirt
Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings...
March 12, 2018: Neurosurgery
John P Kleimeyer, Ivan Cheng, Todd F Alamin, Serena S Hu, Thomas Cha, Vijay Yanamadala, Kirkham B Wood
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To evaluate the long-term outcomes of selective one- to two-level anterior lumbar interbody fusions (ALIFs) in the lower lumbar spine versus continued nonsurgical management. SUMMARY OF BACKGROUND DATA: Low back pain associated with lumbar intervertebral disc degeneration is common with substantial economic impact, yet treatment remains controversial. Surgical fusion has previously provided mixed results with limited durable improvement of pain and function...
March 9, 2018: Spine
Ron N Alkalay, Robert Adamson, Michael W Groff
BACKGROUND CONTEXT: In the lumbar spine, end plate preparation for the interbody fusion cages may critically affect the cage's long term performance. This study investigated the effect of the interbody cage design on the compliance and cage subsidence of instrumented spines under cyclic compression. PURPOSE: To quantify the role of cage geometry and bone density on the stability of the spinal construct in response to cyclic compressive loads. STUDY DESIGN: Changes in the cage-bone interface and the effect of bone density on these changes were evaluated in a human cadaveric model for three intervertebral cage designs...
March 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Gilles Norotte, Carlos Barrios
OBJECTIVE: Recent improvements in cage designs with integral fixation and screw attachments have made stand-alone ALIF a viable option with several possible advantages. The aim of this study was to confirm the efficacy and safety of a PEEK cage filled with hydroxyapatite nanoparticles without adding a bone graft for stand-alone ALIF in the treatment of L5-S1 isolated degenerative disc discopathy (DDD). PATIENTS AND METHODS: Sixty-five patients who required surgery for DDD were evaluated...
January 31, 2018: Clinical Neurology and Neurosurgery
Michael R Riley, Adam T Doan, Richard W Vogel, Alexander O Aguirre, Kayla S Pieri, Edward H Scheid
Background Context Intraoperative neurophysiological monitoring (IONM) has gained rather wide-spread acceptance as a method to mitigate risk to the lumbar plexus during Lateral Lumbar Interbody Fusion (LLIF) surgery. The most common approach to IONM involves using only electromyography (EMG) monitoring, and the rate of postoperative deficit remains unacceptably high. Other test modalities, such as transcranial electric motor-evoked potentials (tcMEPs) and somatosensory-evoked potentials (SSEPs), may be more suitable for monitoring neural integrity but they have not been widely adopted during LLIF...
March 2, 2018: Spine Journal: Official Journal of the North American Spine Society
Aaron J Buckland, Bryan M Beaubrun, Evan Isaacs, John Moon, Peter Zhou, Sam Horn, Gregory Poorman, Jared C Tishelman, Louis M Day, Thomas J Errico, Peter G Passias, Themistocles Protopsaltis
Study Design: Retrospective radiological review. Purpose: To quantify the effect of sitting vs supine lumbar spine magnetic resonance imaging (MRI) and change in anterior displacement of the psoas muscle from L1-L2 to L4-L5 discs. Overview of Literature: Controversy exists in determining patient suitability for lateral lumbar interbody fusion (LLIF) based on psoas morphology. The effect of posture on psoas morphology has not previously been studied; however, lumbar MRI may be performed in sitting or supine positions...
February 2018: Asian Spine Journal
Kamal Woods, Ahtziri Fonseca, Larry E Miller
Introduction Oblique lumbar interbody fusion (OLIF) is a newer procedure that avoids the psoas and lumbosacral plexus due to its oblique trajectory into the retroperitoneal space. While early experience with OLIF is reassuring, the longer-term clinical efficacy has not been well established. The purpose of this study was to describe two-year clinical outcomes with OLIF performed by a single surgeon during the learning curve without the aid of the neuromonitoring. Materials and methods Chart review was performed for the consecutive patients who underwent OLIF by a single surgeon...
December 22, 2017: Curēus
K Farah, T Graillon, P Rakotozanany, S Pesenti, B Blondel, S Fuentes
INTRODUCTION: Circumferential fusion for lumbar low-grade isthmic spondylolisthesis (LGIS) provides the best spinal stability and highest fusion rates. The aim of this study is to investigate results of minimal invasive management of LGIS and correlations between Intervertebral Foramen Surface (IFS) and other parameters. METHODS: We retrospectively reviewed cases of 43 patients who underwent a minimally invasive circumferential fusion (Anterior lumbar interbody fusion followed by percutaneous posterior pedicle screw fixation) for LGIS between January 2010 and December 2014 in our institution...
February 23, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Anshit Goyal, Panagiotis Kerezoudis, Mohammed Ali Alvi, Sandy Goncalves, Mohamad Bydon
A variety of surgical approaches have been described to treat low grade lumbar degenerative spondylolisthesis (DS). Minimally invasive spinal fusion techniques were first introduced to minimize morbidities associated with invasive surgical treatments. Minimally invasive lateral transpsoas interbody fusion, also known as lateral lumbar interbody fusion (LLIF), is a relatively new method of lumbar arthrodesis that avoids various approach related complications compared to its posterior and anterior counterparts...
February 16, 2018: Clinical Neurology and Neurosurgery
Chengzhen Jin, Milin S Jaiswal, Sin-Soo Jeun, Kyeong-Sik Ryu, Jung-Woo Hur, Jin-Sung Kim
BACKGROUND: Oblique lateral interbody fusion (OLIF) offers the solution to problems of anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF). However, OLIF technique for degenerative spinal diseases of elderly patients has been rarely reported. The objective of this study was to determine the clinical and radiological results of OLIF technique for degenerative spinal diseases in patients under or over 65 years of age. METHODS: Sixty-three patients who underwent OLIF procedure were enrolled, including 29 patients who were less than 65 years of age and 34 patients who were over 65 years of age...
February 20, 2018: Journal of Orthopaedic Surgery and Research
Xin Zhao, Chen Chen, Tangjun Zhou, Jie Mi, Lin Du, Zhanrong Kang, Jianming Huang, Kai Zhang, Xiaojiang Sun, Jie Zhao
PURPOSE: The purpose of this study was to investigate the position of single cage inserted using oblique-oriented technique in transforaminal lumbar interbody fusion (TLIF) on digital images of computed tomography (CT). METHODS: From January to August 2015, 44 consecutive patients with degenerative lumbar disease who underwent TLIF in the L4/5 level were retrospectively studied in our department. The single cage was inserted using the oblique-oriented technique; as the main purpose of the study, its position was analyzed using post-operative digital computed tomography images...
February 11, 2018: International Orthopaedics
F Lattig, E Stettin, S Weckbach
OBJECTIVE: Correction of a segmental or global lumbar hypolordosis to improve a sagittal imbalance. INDICATIONS: Lumbar segments fixed in kyphosis; degenerative or posttraumatic hypolordotic deformity of the lumbar spine with sagittal imbalance. CONTRAINDICATIONS: Bechterew disease; extended adhesions in the retroperitoneum. SURGICAL TECHNIQUE: Segmental correction of a kyphotic fixed segment using a unilateral transforaminal approach to release the annulus and anterior longitudinal ligament...
February 2, 2018: Operative Orthopädie und Traumatologie
Mehmet Reşid Önen, Cemile Başgül, İlhan Yılmaz, Mustafa Özkaya, Teyfik Demir, Sait Naderi
Rigid and semi-rigid fixations are investigated several times in order to compare their biomechanical stability. Interbody fusion techniques are also preferable for maintaining the sagittal balance by protecting the disk height. In this study, the biomechanical comparison of semi-rigid and rigid fixations with posterior lumbar interbody fusion or transforaminal lumbar interbody fusion procedures is conducted under trauma. There were four different test groups to analyze the effect of acute load on treated ovine vertebrae...
February 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Weerasak Singhatanadgige, Daniel G Kang, Dol Wiranuwat, Chotetawan Tanavalee, Wicharn Yingsakmongkol, Worawat Limthongkul
PURPOSE: To assess the anatomic path of the middle sacral artery (MSA) at the presacral area and its relationship to the spinal midline during an axial lumbar interbody fusion (AxiaLif) approach. METHODS: Fifty human cadavers (25 males, 25 females) were used in this study. A transabdominal approach was used to expose the anterior aspect of the L5/S1 intervertebral disc and the presacral space. We measured the size and distance from the spinal midline at the following positions: (a) middle of the L5/S1 disc level, (b) 1 cm below the sacral promontory (SP), and (c) 2 cm below the SP...
January 2018: Journal of Orthopaedic Surgery
Kevin Phan, Alan Lackey, Nicholas Chang, Yam-Ting Ho, David Abi-Hanna, Jack Kerferd, Monish M Maharaj, Rhiannon M Parker, Gregory M Malham, Ralph J Mobbs
Background: Recurrent intervertebral disc herniation is a relatively common occurrence after primary discectomy for lumbar intervertebral disc herniation. For recurrent herniations after repeat discectomies, a growing body of evidence suggests that fusion is effective in appropriately selected cases. Theoretically, anterior lumbar interbody fusion (ALIF) allows for comprehensive discectomy, less trauma to spinal nerves and paraspinal muscles and avoidance of the disadvantages of repeat posterior approaches...
December 2017: Journal of Spine Surgery (Hong Kong)
Michael M Safaee, Christopher P Ames, Vedat Deviren, Aaron J Clark
BACKGROUND: Traditional approaches for retroperitoneal lumbar plexus schwannomas involve anterior open or laparoscopic resection. For select tumors, the lateral retroperitoneal approach provides a minimally invasive alternative. OBJECTIVE: To describe a minimally invasive lateral transpsoas approach for the resection of retroperitoneal schwannomas. METHODS: A lateral retroperitoneal transpsoas approach was used to resect a 3.1 × 2.7 × 4...
January 17, 2018: Operative Neurosurgery (Hagerstown, Md.)
Neginder Saini, Mohammad Zaidi, Maureen T Barry, Robert F Heary
Anterior lumbar interbody fusion (ALIF) is a widely performed surgical treatment for various lumbar spine pathologies. The authors present the first reports of virtually identical cases of complications with integrated screws in stand-alone interbody cages. Two patients presented with the onset of S-1 radiculopathy due to screw misplacements following an ALIF procedure. In both cases, an integrated screw from the cage penetrated the dorsal aspect of the S-1 cortical margin of the vertebra, extended into the neural foramen, and injured the traversing left S-1 nerve roots...
January 5, 2018: Journal of Neurosurgery. Spine
David S Xu, Konrad Bach, Juan S Uribe
OBJECTIVE Minimally invasive anterior and lateral approaches to the lumbar spine are increasingly used to treat and reduce grade I spondylolisthesis, but concerns still exist for their usage in the management of higher-grade lesions. The authors report their experience with this strategy for grade II spondylolisthesis in a single-surgeon case series and provide early clinical and radiographic outcomes. METHODS A retrospective review of a single surgeon's cases between 2012 and 2016 identified all patients with a Meyerding grade II lumbar spondylolisthesis who underwent minimally invasive lateral lumbar interbody fusion (LLIF) or anterior lumbar interbody fusion (ALIF) targeting the slipped level...
January 2018: Neurosurgical Focus
Peter G Campbell, Pierce D Nunley, David Cavanaugh, Eubulus Kerr, Philip Andrew Utter, Kelly Frank, Marcus Stone
OBJECTIVE Recently, authors have called into question the utility and complication index of the lateral lumbar interbody fusion procedure at the L4-5 level. Furthermore, the need for direct decompression has also been debated. Here, the authors report the clinical and radiographic outcomes of transpsoas lumbar interbody fusion, relying only on indirect decompression to treat patients with neurogenic claudication secondary to Grade 1 and 2 spondylolisthesis at the L4-5 level. METHODS The authors conducted a retrospective evaluation of 18 consecutive patients with Grade 1 or 2 spondylolisthesis from a prospectively maintained database...
January 2018: Neurosurgical Focus
Craig A Kuhns, Jonathan A Harris, Mir M Hussain, Aditya Muzumdar, Brandon S Bucklen, Saif Khalil
Study Design: In vitro biomechanical investigation. Purpose: To compare the biomechanics of integrated three-screw and four-screw anterior interbody spacer devices and traditional techniques for treatment of degenerative disc disease. Overview of Literature: Biomechanical literature describes investigations of operative techniques and integrated devices with four dual-stacked, diverging interbody screws; four alternating, converging screws through a polyether-ether-ketone (PEEK) spacer; and four converging screws threaded within the PEEK spacer...
December 2017: Asian Spine Journal
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