Short-term clinical outcomes and safety evaluation of extreme lateral interbody fusion for the treatment of lumbar degenerative diseases

Abstract

Objective To investigate the short-term clinical effect and safety of extreme lateral interbody fusion (XLIF) for the treatment of lumbar degenerative diseases.Methods Sixteen patients (6 males and 10 females) with an average age of 62 (36 to 82) years were included,consisting of lumbar spinal instability in 9 cases and lumbar spinal stenosis in 7 cases.All patients had undergone XLIF procedure with posterior percutaneous pedicle screw fixation from September 2009 to January 2013.The fusion level was one in 11 cases,two in 4 cases,and three in 1 case.The visual analogue scale (VAS),Oswestry disability index (ODI) and Macnab criteria were used to assess the clinical effect postoperatively while X-ray and CT were used to evaluate the fusion.The operation time,blood loss and postoperative complications were also analyzed.Results Mean operation time and blood loss for discectomy and interbody placement was 75 min and 83 ml per level.We found transient thigh numbness and weakness of hip flexor in 2 cases,which resumed automatically within 2 weeks.All patients were followed up for an average of 15 (6 to 48) months.The VAS score was 4.6 and 3.1 lower in back pain and leg pain while ODI score was 50％ lower in six months postoperatively.According to the Macnab criteria,the excellent and good rate was 87.5％.There were 4 complete fusion cases and 11 partial fusion cases in 6 months.7 cases out of 8 achieved complete fusion while 1 case achieved partial fusion after 12 months.The fusion rate was 87.5％.Conclusion XLIF can provide a satisfactory short-term outcome for the treatment of lumbar degenerative diseases. Key words: Spinal fusion; Lumbar vertebrae; Intervertebral disc degeneration