A Comparative Study of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion in Degenerative Lumbar Spondylolisthesis

Abhijit Y. Pawar; Alexander P. Hughes; Andrew A. Sama; Federico P. Girardi; Darren R. Lebl; Frank P. Cammisa

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자료유형: 학술저널

저자정보: Abhijit Y. Pawar (Ruby Hall Clinic and Dr. D. Y. Patil Medical College) Alexander P. Hughes (Hospital for Special Surgery) Andrew A. Sama (Hospital for Special Surgery) Federico P. Girardi (Hospital for Special Surgery) Darren R. Lebl (Hospital for Special Surgery) Frank P. Cammisa (Hospital for Special Surgery)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.9 No.5

발행연도: 2015.1

수록면: 668 - 674 (7page)

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Study Design: Level 4 retrospective review. Purpose: To compare the radiographic and clinical outcomes between posterior lumbar interbody fusion (PLIF) and lateral lumbar interbody fusion (LLIF) with posterior segmental spinal instrumentation (SSI) for degenerative lumbar spondylolisthesis. Overview of Literature: Both PLIF and LLIF have been performed for degenerative spondylolisthesis with good results, but no study has directly compared these two techniques so far. Methods: The electronic medical and radiographic records of 78 matched patients were analyzed. In one group, 39 patients underwent PLIF with SSI at 41 levels (L3–4/L4–5), while in the other group, 39 patients underwent the LLIF procedure at 48 levels (L3–4/ L4–5). Radiological outcomes such as restoration of disc height and neuroforaminal height, segmental lumbar lordosis, total lumbar lordosis, incidence of endplate fracture, and subsidence were measured. Perioperative parameters were also recorded in each group. Clinical outcome in both groups was assessed by the short form-12, Oswestry disability index and visual analogue scale scores. The average follow-up period was 16.1 months in the LLIF group and 21 months in the PLIF group. Results: The restoration of disc height, foraminal height, and segmental lumbar lordosis was significantly better in the LLIF group (p <0.001). The duration of the operation was similar in both groups, but the average blood loss was significantly lower in the LLIF group (p <0.001). However, clinical outcome scores were similar in both groups. Conclusions: Safe, effective interbody fusion can be achieved at multiple levels with neuromonitoring by the lateral approach. LLIF is a viable treatment option in patients with new onset symptoms due to degenerative spondylolisthesis who have had previous lumbar spine surgery, and it results in improved sagittal alignment and indirect foraminal decompression.

참고문헌 (4)

참고문헌 신청

Isaacs RE / 2010 / A prospective, nonrandomized, multicenter evaluation of extreme lateral interbody fusion for the treatment of adult degenerative scoliosis: perioperative outcomes and complications / Spine (Phila Pa 1976) 35(26 Suppl):S322~S330

Xu H / 2013 / Biomechanical comparison of posterior lumbar interbody fusion and transforaminal lumbar interbody fusion by finite element analysis / Neurosurgery 72(1 Suppl Operative):21~26

Oliveira L / 2010 / A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements / Spine (Phila Pa 1976) 35(26 Suppl):S331~S337

Youssef JA / 2010 / Minimally invasive surgery. Lateral approach interbody fusion: results and review / Spine (Phila Pa 1976) 35(26 Suppl):S302~S311

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Abhijit Y. Pawar

소속기관 Ruby Hall Clinic and Dr. D. Y. Patil Medical College

주요연구분야 의약학 > 임상의학 > 정형외과학

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Alexander P. Hughes