Instrumentation choice and early radiographic outcome following lateral lumbar interbody fusion (LLIF): Lateral instrumentation versus posterior pedicle screw fixation

Lateral lumbar interbody fusion (LLIF) is a minimally invasive fusion procedure that may be performed with or without supplemental instrumentation. However, there is a paucity of evidence on the effect of supplemental instrumentation technique on perioperative morbidity and fusion rate in LLIF. A si...

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Bibliographic Details
Published in:North American Spine Society journal (NASSJ) 2022-12, Vol.12, p.100176-100176, Article 100176
Main Authors: Nuss, Sarah, Leary, Owen P., Zheng, Bryan, Darveau, Spencer C., Barrios-Anderson, Adriel, Niu, Tianyi, Gokaslan, Ziya L., Sampath, Prakash, Telfeian, Albert E., Oyelese, Adetokunbo A., Fridley, Jared S.
Format: Article
Language:English
Subjects:
Clinical Studies
Lateral lumbar interbody fusion
LLIF
Lumbar Spine
Minimally invasive spine surgery
Spinal instrumentation
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Summary:Lateral lumbar interbody fusion (LLIF) is a minimally invasive fusion procedure that may be performed with or without supplemental instrumentation. However, there is a paucity of evidence on the effect of supplemental instrumentation technique on perioperative morbidity and fusion rate in LLIF. A single-institutional retrospective review of patients who underwent LLIF for lumbar spondylosis was conducted. Patients were grouped according to supplemental instrumentation technique: stand-alone LLIF, LLIF with laterally placed instrumentation, or LLIF with posterior percutaneous pedicle screw fixation (PPSF). Outcomes included fusion rates, peri-operative complication, and reoperation; estimated blood loss (EBL); surgery duration; length of stay; and length of follow-up. 82 patients underwent LLIF at 114 levels. 35 patients (42.7%) received supplemental lateral instrumentation, 30 (36.6%) received supplemental PPSF, and 17 (20.7%) underwent stand-alone LLIF. More patients in the lateral instrumentation group had prior lumbar fusion at adjacent levels (23/35, 65.71%) versus stand-alone (3/17, 17.6%) or PPSF (2/30, 6.67%) groups (p = 0.003). 4/17 patients (23.5%) with stand-alone LLIF and 4/35 patients (11.42%) with lateral instrumentation underwent reoperation, versus 0/30 with PPSF (p = 0.030). There was no difference in fusion rates between groups (p = 0.717). Operation duration was longer in patients with PPSF (p 
ISSN:2666-5484
2666-5484
DOI:10.1016/j.xnsj.2022.100176