title: Extreme lateral lumbar interbody fusion. Surgical technique, outcomes and complications after a minimum of one year follow-up.
abstract: «Minimally invasive» techniques have been recently been developed in order to achieve good clinical results with a low incidence of complications. The extralateral interbody fusion or direct transpsoas is a minimally invasive anterior arthrodesis. A total of 97 patients with 138 segments received surgery between May 2012 and May 2015. The follow-up was from 12-44 months. The mean age was 68 years (41-86). The most common cause of intervention was the adjacent segment (30%), deformity (22%), and lumbar disc disease (21%). The interbody cage was implanted as: Single (stand-alone) in 33%, and additional fixation was used in the others: Screws, percutaneous unilateral (11%), bilateral (27%), or with a lateral plate (62%). The mean stay was 3.2 days (2-6). The score on a lumbar visual analogue scale decreased from 9 to 4.1, and dropped to 3 after one year. The improvement in disc height was from 8.4mm to 13.8mm, and a larger increase in the foramen diameter from 10.5 to 13.1mm, which were statistically significant. The early major complications recorded were, three motor femoral nerve injuries and retroperitoneal haematoma (4%), and the early minor were: two fractures (2%). As major late complications there was an abdominal hernia, a mobilization of 10mm and three radiculopathy (5%), and as minor late, three fracture, two mobilisations greater than 10mm, four mobilisations of less than 10mm, and one mobilisation of a screw plate (10%). The extralateral interbody fusion technique is a safe and reliable when performing a lumbar fusion by an alternative minimally invasive route.
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínico San Carlos, Madrid, España. Electronic address: ndominguez03@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Domínguez
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Luque
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Noriega
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Rey
authors.affiliation: Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Alia
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: F
authors.initials: F
authors.lastname: Marco-Martínez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*
keywords: Artrodesis intersomática extralateral; Complicaciones; Complications; Extra-lateral body fusion; Outcomes; Resultados