Abstract
Extreme lateral interbody fusion (XLIF; NuVasive Inc., San Diego, CA, USA) is a minimally
invasive lateral transpsoas approach to the thoracolumbar spine. Though the procedure
is rapidly increasing in popularity, limited data is available regarding its use in
deformity surgery. We aimed to evaluate radiographic correction using XLIF in adults
with degenerative lumbar scoliosis. Thirty consecutive patients were followed for
an average of 14.3 months. Interbody fusion was completed using the XLIF technique with supplemental
posterior instrumentation. Plain radiographs were obtained on all patients preoperatively,
postoperatively, and at most recent follow-up. Plain radiographic measurements of
coronal Cobb angle, apical vertebral translation, segmental lordosis, global lordosis,
disc height, neuroforaminal height and neuroforaminal width were made at each time
point. CT scans were obtained for all patients 1 year after surgery to evaluate for fusion. There was significant improvement in multiple
radiographic parameters from preoperative to postoperative. Cobb angle corrected 72.3%,
apical vertebral translation corrected 59.7%, neuroforaminal height increased 80.3%,
neuroforaminal width increased 7.4%, and disc height increased 116.7%. Segmental lordosis
at L4–L5 increased 14.1% and global lordosis increased 11.5%. There was no significant
loss of correction from postoperative to most recent follow-up. There was an 11.8%
pseudoarthrosis rate at levels treated with XLIF. Complications included lateral incisional
hernia (n = 1), rupture of anterior longitudinal ligament (n = 2), wound breakdown (n = 2), cardiac instability (n = 1), pedicle fracture (n = 1), and nonunion requiring revision (n = 1). XLIF significantly improves coronal plane deformity in patients with adult degenerative
scoliosis. XLIF has the ability to correct sagittal plane deformity, although it is
most effective at lower lumbar levels.
Keywords
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Article info
Publication history
Accepted:
December 8,
2012
Received:
May 25,
2012
Footnotes
☆Disclosures: Christopher R. Brown and Robert E. Isaacs have a financial relationship with NuVasive, Inc. Adam M. Caputo, Keith W. Michael, Todd M. Chapman, Jason M. Jennings, and Elizabeth W. Hubbard have no disclosures.
Identification
Copyright
© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
