title: Fusion rate following extreme lateral lumbar interbody fusion.
abstract: BACKGROUND
  Lumbar fusion has been found to be a clinically effective procedure in adult patients. The lateral transpsoas approach allows for direct visualization of the intervertebral space, significant support of the vertebral anterior column, while avoiding the complications associated with the posterior procedures. The aim of this study is to determine the fusion rate of inter body fusion using computed tomography in patients treated by extreme lateral intersomatic fusion (XLIF) technique.
  
  
  METHODS
  All patients intervened by XLIF procedure between 2009 and 2013 by a single operating team at a single institution were recruited for this study. A clinical evaluation and a CT scan of the involved spinal segments were then performed with at least 1-year follow-up following the standard clinical practice in the center.
  
  
  RESULTS
  A total of 77 patients met inclusion criteria, of which 53 were available for review with a mean follow-up of 34.5 (12-62) months. A total of 68 (87.1 %) of the 78 operated levels were considered as completely fused, 8 (10.2 %) were considered as stable, probably fused, and 2 (2.6 %) of the operated levels were diagnosed as pseudarthrosis. When stratified by type of graft material complete fusion was obtained in 75 % of patients in which autograft was used to fill the cages, compared to 89 % of patients in which calcium triphosphate was used, and 83 % of patients in which Attrax™ was used.
  
  
  CONCLUSIONS
  Reports of XLIF fusion rate in the literature vary from 85 to 93 % at 1-year follow-up. Fusion rate in our series corroborates data from previous publications. The results of this series confirm that anterior inter body fusion by means of XLIF approach is a technique that achieves high fusion rate and satisfactory clinical outcomes.
authors.affiliation: IVth Spine Surgery Division, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
authors.forename: Pedro
authors.initials: P
authors.lastname: Berjano
authors.forename: Francesco
authors.initials: F
authors.lastname: Langella
authors.forename: Marco
authors.initials: M
authors.lastname: Damilano
authors.forename: Matteo
authors.initials: M
authors.lastname: Pejrona
authors.forename: Josip
authors.initials: J
authors.lastname: Buric
authors.forename: Maryem
authors.initials: M
authors.lastname: Ismael
authors.forename: Jorge Hugo
authors.initials: JH
authors.lastname: Villafañe
authors.forename: Claudio
authors.initials: C
authors.lastname: Lamartina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration; D019736:Prostheses and Implants; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D014057:Tomography, X-Ray Computed; D064232:Visual Analog Scale; D055815:Young Adult