Long-Term Durability of Stand-Alone Lateral Lumbar Interbody Fusion

Neurosurgery 93:60–65, 2023

BACKGROUND: The long-term durability of stand-alone lateral lumbar interbody fusion (LLIF) remains unknown.

OBJECTIVE: To evaluate whether early patient-reported outcome measures after stand-alone LLIF are sustained on long-term follow-up.

METHODS: One hundred and twenty-six patients who underwent stand-alone LLIF between 2009 and 2017 were included in this study. Patient-reported outcome measures included the Oswestry Disability Index (ODI), EuroQOL-5D (EQ-5D), and visual analog score (VAS) scores. Durable outcomes were defined as scores showing a significant improvement between preoperative and 6-week scores without demonstrating any significant decline at future time points. A repeated measures analysis was conducted using generalized estimating equations (model) to assess the outcome across different postoperative time points, including 6 weeks, 1 year, 2 years, and 5 years.

RESULTS: ODI scores showed durable improvement at 5-year follow-up, with scores improving from 46.9 to 38.5 (P = .001). Improvements in EQ-5D showed similar durability up to 5 years, improving from 0.48 to 0.65 (P = .03). VAS scores also demonstrated significant improvements postoperatively that were durable at 2-year follow-up, improving from 7.0 to 4.6 (P < .0001).

CONCLUSION: Patients undergoing stand-alone LLIF were found to have significant improvements in ODI and EQ-5D at 6week follow-up that remained durable up to 5 years postoperatively. VAS scores were found to be significantly improved at 6 weeks and up to 2 years postoperatively but failed to reach significance at 5 years. These findings demonstrate that patients undergoing stand-alone LLIF show significant improvement in overall disability after surgery that remains durable at long-term follow-up.