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Minimally Invasive Lateral Lumbar Interbody Fusion: Clinical and Radiographic Outcome at a Minimum 2-year Follow-up.
MedLine Citation:
PMID:  22964885     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STUDY DESIGN:: Retrospective case series. OBJECTIVE:: To determine the clinical and radiographic outcomes of patients undergoing minimally invasive lateral lumbar interbody fusion (LLIF) with a minimum 2-year follow-up. SUMMARY OF BACKGROUND DATA:: Minimally invasive LLIF is performed through a lateral, retroperitoneal, transpsoas approach. This procedure is characterized by the use of a tubular retractor to minimize tissue damage and real-time neuromonitoring to ensure safe passage through the psoas muscle. To date, advantages of minimal invasive LLIF, compared to open procedures, has been limited to early postoperative outcomes and complications, with the longest mean follow-up duration of 22 months. METHODS:: 118 patients who underwent minimally invasive LLIF with a minimum of 2 years follow-up were included in this study. Clinical outcomes were determined by using Visual Analog Score (VAS) for the degree of pain (trunk or lower extremity), and Oswestry Disability Index (ODI) and Short Form-12 (SF-12) scoring methods for patient function. Radiographic evaluations included (i) disc height, (ii) segmental coronal angulation, (iii) segmental lordotic angulation, (iv) Cobb angle, (v) cage subsidence, and (vi) fusion status. Data were statistically tested using either paired Students-t-test or Wilcoxon matched pair test. Significance levels was set at P<0.05. RESULTS:: We found (i) that the VAS for pain, Oswestry Disability Index and the physical components summary, but not the mental components summary of Short Form-12 improved significantly at the follow-up, (ii) that disc height, coronal angulation, and lordotic angulation at each level and the Cobb angle were restored at the statistically significant extent, (iii) that successful fusion was achieved in 209 levels (88%), and (iv) that transient thigh pain was the most frequent complications seen in 36% of the patients. Conclusions. Our results support the efficacy of minimally invasive LLIF in improvements of clinical and radiographic features.
Authors:
Suhel Kotwal; Satoshi Kawaguchi; Darren Lebl; Alexander Hughes; Russel Huang; Andrew Sama; Frank Cammisa; Federico Girardi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-6
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  -     ISSN:  1539-2465     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Asst. Professor of Orthopedic surgery, University of Missouri at Kansas City, MO †Clinical fellow, MD Anderson Cancer Center, TX ‡Attending surgeon, Hospital for Special Surgery, NY.
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