Tag: Lateral lumbar interbody fusion (LLIF)

Posted on

Fully Navigated Single-Position Prone Lateral Lumbar Interbody Fusion: A Detailed Technical Report and Description of 15 Cases

Int J Spine Surg 2025, 19 (1) 70-80

Surgical Technique and Study Overview

• Single-position prone lateral lumbar interbody fusion improves surgery efficiency and safety.

• Navigation enhances precision in pedicle screw placement and reduces radiation exposure.

• Study involved 15 patients with simultaneous cage and screw placement using intraoperative navigation.

• Mean surgery duration was 263 ± 94 minutes with blood loss of 315 ± 143 mL.

• No major complications reported, except for two cases of cerebrospinal fluid leakage.

Clinical Outcomes and Findings

• Significant improvements in Oswestry Disability Index (ODI) scores post-surgery (51.38 to 32.81).

• Segmental lordosis improved significantly from 3.26° to 13.09° (P < 0.001).

• No significant changes in total lumbar lordosis or sagittal vertical axis.

Technical Insights and Considerations

• Intraoperative navigation used for cage and screw placement without additional fluoroscopy.

• Radiation exposure reduced for surgical teams due to minimized fluoroscopy use.

• Simultaneous screw and cage placement guided by navigation and neuromonitoring.

• Challenges include navigation system inaccuracies due to segmental distraction.

• Learning curve observed with new workflow implementation affecting time savings.

Posted on

Incidence of major and minor vascular injuries during lateral access lumbar interbody fusion procedures

Neurosurgical Review (2022) 45:1275–1289

During lateral lumbar fusion, the trajectory of implant insertion approaches the great vessels anteriorly and the segmental arteries posteriorly, which carries the risk of vascular complications.

We aimed to analyze vascular injuries for potential differences between oblique lateral interbody fusion (OLIF) and lateral lumbar interbody fusion (LLIF) procedures at our institution. This was coupled with a systematic literature review of vascular complications associated with lateral lumbar fusions. A retrospective chart review was completed to identify consecutive patients who underwent lateral access fusions. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used for the systematic review with the search terms “vascular injury” and “lateral lumbar surgery.”

Of 260 procedures performed at our institution, 211 (81.2%) patients underwent an LLIF and 49 (18.8%) underwent an OLIF. There were no major vascular complications in either group in this comparative study, but there were four (1.5%) minor vascular injuries (2 LLIF, 0.95%; 2 OLIF, 4.1%). Patients who experienced vascular injury experienced a greater amount of blood loss than those who did not (227.5 ± 147.28 vs. 59.32 ± 68.30 ml) (p = 0.11). In our systematic review of 63 articles, major vascular injury occurred in 0–15.4% and minor vascular injury occurred in 0–6% of lateral lumbar fusions.

The systematic review and comparative study demonstrate an increased rate of vascular injury in OLIF when compared to LLIF. However, vascular injuries in either procedure are rare, and this study aids previous literature to support the safety of both approaches.

Proudly powered by WordPress