Retroperitoneal approach for lumbar interbody fusion with anterolateral instrumentation for treatment of spondylolisthesis and degenerative foraminal stenosis.
BACKGROUND
An alternative approach for the treatment of the degenerative or unstable lumbar spine using retroperitoneal lateral LIF with anterolateral screw-plate or screw-rod fixation is introduced. Special attention is given to application of this procedure in patients who have undergone prior lumbar surgery.


METHODS
Between 1998 and 2001, 14 patients underwent lateral LIF with anterolateral instrumentation to treat degenerative foraminal stenosis or spondylolisthesis. Eleven patients (79%) had undergone prior posterior lumbar surgery, 7 of whom were also fused at that time. All patients first presented with mechanical back pain, radicular pain, or both. The mean follow-up was 21 months (range, 8 to 36 months).


RESULTS
Radicular pain and mechanical back pain significantly improved in 71% and 54% of patients, respectively. Of the 9 patients with preoperative neurological deficits, 7 were intact or had improved at their follow-up examination. One patient developed postoperative radiculopathy contralateral to his original symptoms. Radiography confirmed good positioning of the hardware and evidence of fusion in all 14 patients. No major complications occurred.


CONCLUSIONS
Retroperitoneal lateral LIF with anterolateral instrumentation is an attractive alternative for the treatment of the degenerative or unstable lumbar spine in the absence of significant spinal stenosis. This approach is particularly useful for treating spondylolisthesis or degenerative foraminal stenosis in the postoperative lumbar spine.
Klopfenstein
Jeffrey D
JD
Division of Neurological Surgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA.
Kim
Louis J
LJ
Feiz-Erfan
Iman
I
Dickman
Curtis A
CA
D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000473:pathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000473:pathology / Q000601:surgery; D011843:Radiculopathy / Q000473:pathology / Q000601:surgery; D012086:Reoperation / Q000379:methods*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013168:Spondylolisthesis / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome