Abstract
Revision surgery to address the migration or fracture of a lumbar interbody cage can be technically challenging. Scar tissue and fibrosis, among other anatomic barriers, can make removal of the cage a complicated procedure, potentially increasing postoperative pain as well as the probability of neurologic deficits. Use of the lateral surgical technique for removal of the cage can avoid these potential complications. In this case report, we describe the removal of interbody cages through a lateral approach in three patients without the necessity of additional posterior hardware revision.
Highlights
A lateral interbody fusion is a minimally invasive, transpsoas, retroperitoneal surgical approach to the thoracic and lumbar intervertebral disc space [1]
We describe the removal of interbody cages through a lateral approach in three patients without the necessity of additional posterior hardware revision
We discuss our experience with the lateral retrieval of interbody cages that have migrated, fractured, or not fused, and subsequently required surgical intervention but did not require posterior hardware revision
Summary
A lateral interbody fusion is a minimally invasive, transpsoas, retroperitoneal surgical approach to the thoracic and lumbar intervertebral disc space [1]. Few studies have been published discussing this approach for cage removal not requiring posterior hardware revision [3,4] In this case report, we discuss our experience with the lateral retrieval of interbody cages that have migrated, fractured, or not fused, and subsequently required surgical intervention but did not require posterior hardware revision. In the second patient case, a 52-year-old female was evaluated in clinic with symptoms of significant neurogenic claudication, radicular pain, and lower extremity weakness two years status post posterior lumbar interbody fusion at L3-4. There are some constraints placed on the size of the new cage since there is already posterior fixation, the goal of this revision surgery is not to maintain a significant amount of added indirect decompression, but to provide stabilization to the anterior column
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