title: Extreme lateral approach to the spine in degenerative and post traumatic lumbar diseases: selection process, results and complications.
abstract: OBJECTIVE
  The aim of this study is to describe clinical and radiological outcomes as well as accompanying complications in a series of consecutive lateral transpsoas approaches (XLIF).
  
  
  METHODS
  A retrospective study of 39 patients treated for degenerative and post-traumatic lumbar diseases was carried out. Functional status, leg and back pain and radiological outcomes were evaluated pre and post-operatively using the Oswestry disability index score (ODI) visual analog scales (VAS) and X-ray studies.
  
  
  RESULTS
  Mean follow-up was 16 months (range 12-24 months). Mean improvement in back and leg pain on VAS was 6.08 (p < 0.01) and 2.77 (p < 0.01), respectively. Mean improvement in the ODI score was 38 (p < 0.01). Increases in lumbar lordosis (32.8°-39.2°, p < 0.05) and disc height (3.6-4.8 mm, p < 0.05) were noted in the post-operative. Mild, transient strength deficit of the quadriceps muscle was also noted in ten cases with complete regression.
  
  
  CONCLUSIONS
  XLIF proved to be a safe, effective, minimally invasive technique that allows valid arthrodesis to be carried out. Patients achieved positive clinical outcomes and satisfactory fusion rates, with sustained restoration of lordosis, spinal alignment and disc height.
authors.affiliation: Clinica Ortopedica, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genova, Italy, dott.formica@gmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Formica
authors.forename: Pedro
authors.initials: P
authors.lastname: Berjano
authors.forename: Luca
authors.initials: L
authors.lastname: Cavagnaro
authors.forename: Andrea
authors.initials: A
authors.lastname: Zanirato
authors.forename: Andrea
authors.initials: A
authors.lastname: Piazzolla
authors.forename: Carlo
authors.initials: C
authors.lastname: Formica
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion