Skip to main content
Top
Published in: Acta Neurochirurgica 1/2024

01-12-2024 | Original Article

Lateral-PLIF for spinal arthrodesis: concept, technique, results, complications, and outcomes

Authors: Gabriele Capo, Francesco Calvanese, Alberto Vandenbulcke, Ismail Zaed, Davide Tiziano Di Carlo, Roberta Cao, Cédric Y. Barrey

Published in: Acta Neurochirurgica | Issue 1/2024

Login to get access

Abstract

Background

Posterior lumbar interbody fusion (PLIF) surgery represents an effective option to treat degenerative conditions in the lumbar spine. To reduce the drawbacks of the classical technique, we developed a variant, so-called Lateral-PLIF, which we then evaluated through a prospective consecutive series of patients.

Methods

All adult patients treated at our institute with single or double level Lateral-PLIF for lumbar degenerative disease from January to December 2017 were prospectively collected. Exclusion criteria were patients < 18 years of age, traumatic patients, active infection, or malignancy, as well as unavailability of clinical and/or radiological follow-up data. The technique consists of insert the cages bilaterally through the transition zone between the central canal and the intervertebral foramen, just above the lateral recess. Pre- and postoperative (2 years) questionnaires and phone interviews (4 years) assessed pain and functional outcomes. Data related to the surgical procedure, postoperative complications, and radiological findings (1 year) were collected.

Results

One hundred four patients were selected for the final analysis. The median age was 58 years and primary symptoms were mechanical back pain (100, 96.1%) and/or radicular pain (73, 70.2%). We found a high fusion rate (95%). A statistically significant improvement in functional outcome was also noted (ODI p < 0.001, Roland-Morris score p < 0.001). Walking distance increased from 812 m ± 543 m to 3443 m ± 712 m (p < 0.001). Complications included dural tear (6.7%), infection/wound dehiscence (4.8%), and instrument failure (1.9%) but no neurological deterioration.

Conclusions

Lateral-PLIF is a safe and effective technique for lumbar interbody fusion and may be considered for further comparative study validation with other techniques before extensive use to treat lumbar degenerative disease.
Literature
2.
go back to reference Aoki Y, Yamagata M, Ikeda Y, Nakajima F, Ohtori S, Nakagawa K, Nakajima A, Toyone T, Orita S, Takahashi K (2012) A prospective randomized controlled study comparing transforaminal lumbar interbody fusion techniques for degenerative spondylolisthesis: unilateral pedicle screw and 1 cage versus bilateral pedicle screws and 2 cages. J Neurosurg Spine 17:153–159. https://doi.org/10.3171/2012.5.Spine111044CrossRefPubMed Aoki Y, Yamagata M, Ikeda Y, Nakajima F, Ohtori S, Nakagawa K, Nakajima A, Toyone T, Orita S, Takahashi K (2012) A prospective randomized controlled study comparing transforaminal lumbar interbody fusion techniques for degenerative spondylolisthesis: unilateral pedicle screw and 1 cage versus bilateral pedicle screws and 2 cages. J Neurosurg Spine 17:153–159. https://​doi.​org/​10.​3171/​2012.​5.​Spine111044CrossRefPubMed
3.
go back to reference Audat Z, Moutasem O, Yousef K, Mohammad B (2012) Comparison of clinical and radiological results of posterolateral fusion, posterior lumbar interbody fusion and transforaminal lumbar interbody fusion techniques in the treatment of degenerative lumbar spine. Singapore Med J 53:183–187PubMed Audat Z, Moutasem O, Yousef K, Mohammad B (2012) Comparison of clinical and radiological results of posterolateral fusion, posterior lumbar interbody fusion and transforaminal lumbar interbody fusion techniques in the treatment of degenerative lumbar spine. Singapore Med J 53:183–187PubMed
7.
go back to reference Brantigan JW, Steffee AD, Lewis ML, Quinn LM, Persenaire JM (2000) Lumbar interbody fusion using the Brantigan I/F cage for posterior lumbar interbody fusion and the variable pedicle screw placement system: two-year results from a Food and Drug Administration investigational device exemption clinical trial. Spine (Phila Pa 1976) 25:1437–1446. https://doi.org/10.1097/00007632-200006010-00017CrossRefPubMed Brantigan JW, Steffee AD, Lewis ML, Quinn LM, Persenaire JM (2000) Lumbar interbody fusion using the Brantigan I/F cage for posterior lumbar interbody fusion and the variable pedicle screw placement system: two-year results from a Food and Drug Administration investigational device exemption clinical trial. Spine (Phila Pa 1976) 25:1437–1446. https://​doi.​org/​10.​1097/​00007632-200006010-00017CrossRefPubMed
10.
go back to reference Cloward RB (1985) Posterior lumbar interbody fusion updated. Clin Orthopaed Related Res 193:16–19CrossRef Cloward RB (1985) Posterior lumbar interbody fusion updated. Clin Orthopaed Related Res 193:16–19CrossRef
11.
go back to reference Cloward RB (1981) Spondylolisthesis: treatment by laminectomy and posterior interbody fusion. Clin Orthopaed Related Res 154:74–82CrossRef Cloward RB (1981) Spondylolisthesis: treatment by laminectomy and posterior interbody fusion. Clin Orthopaed Related Res 154:74–82CrossRef
19.
24.
go back to reference Hsieh PC, Koski TR, O’Shaughnessy BA, Sugrue P, Salehi S, Ondra S, Liu JC (2007) Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion: implications for the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance. J Neurosurg Spine 7:379–386. https://doi.org/10.3171/spi-07/10/379CrossRefPubMed Hsieh PC, Koski TR, O’Shaughnessy BA, Sugrue P, Salehi S, Ondra S, Liu JC (2007) Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion: implications for the restoration of foraminal height, local disc angle, lumbar lordosis, and sagittal balance. J Neurosurg Spine 7:379–386. https://​doi.​org/​10.​3171/​spi-07/​10/​379CrossRefPubMed
37.
go back to reference Nakai S, Yoshizawa H, Kobayashi S (1999) Long-term follow-up study of posterior lumbar interbody fusion. J Spinal Disord 12:293–299CrossRefPubMed Nakai S, Yoshizawa H, Kobayashi S (1999) Long-term follow-up study of posterior lumbar interbody fusion. J Spinal Disord 12:293–299CrossRefPubMed
43.
go back to reference Resnick DK, Choudhri TF, Dailey AT, Groff MW, Khoo L, Matz PG, Mummaneni P, Watters WC 3rd, Wang J, Walters BC, Hadley MN (2005) Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 7: intractable low-back pain without stenosis or spondylolisthesis. J Neurosurg Spine 2:670–672. https://doi.org/10.3171/spi.2005.2.6.0670CrossRefPubMed Resnick DK, Choudhri TF, Dailey AT, Groff MW, Khoo L, Matz PG, Mummaneni P, Watters WC 3rd, Wang J, Walters BC, Hadley MN (2005) Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 7: intractable low-back pain without stenosis or spondylolisthesis. J Neurosurg Spine 2:670–672. https://​doi.​org/​10.​3171/​spi.​2005.​2.​6.​0670CrossRefPubMed
Metadata
Title
Lateral-PLIF for spinal arthrodesis: concept, technique, results, complications, and outcomes
Authors
Gabriele Capo
Francesco Calvanese
Alberto Vandenbulcke
Ismail Zaed
Davide Tiziano Di Carlo
Roberta Cao
Cédric Y. Barrey
Publication date
01-12-2024
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-024-06024-y

Other articles of this Issue 1/2024

Acta Neurochirurgica 1/2024 Go to the issue