gms | German Medical Science

Objective: Extreme lateral interbody fusion (XLIF) has become the standard of minimally invasive therapy of lumbar scoliosis due to minimally invasive access to the spine, less blood loss compared to open procedures, decreased operative times, shorter hospital stays, and less postoperative pain. Our objective is to determine the safety and efficacy of extreme lateral lumbar interbody fusion (XLIF) with supplemented instrumentation in degenerative spinal canal stenosis and spondylodiscitis.

Methods: Patients who were treated with XLIF at our department in the period 2012-2018 were retrospectively analysed. Patient records with clinical and radiographical data were evaluated.

Results: There were 38 male and 28 female patients. 43 patients had spinal canal stenosis and 25 patients had spondylodiscitis. The mean follow up was 17.8 months. Indications included segmental lumbar scoliosis and the bilateral stenosis of the neuroforamen. One level XLIF was performed in 45 patients, 2 levels in 13 and 3 levels in 10 patients. All but one patient received an additional dorsal stabilization. The pain was present in all patients preoperatively with medium VAS of 7.6±2.3. Postoperatively VAS was significantly improved at 3.4±2.1 (p<0.05). A preoperative neurological deficit was found in 14 patients. Only three patients had a neurological deterioration, 11 patients improved and 54 patients remained unchanged. Complications occurred in 8 patients: in 2 patients screw displacement, in 3 patients wound healing deficit, in 2 patients pneumothorax and in 1 patient retroperitoneal hematoma. There were two cases of cage sintering. Non-union occurred in 5 cases. There were no outcome differences with regard to pain and neurological outcome between patients with spinal canal stenosis and spondylodiscitis as well as between patients with one level vs. multilevel surgery.

Conclusion: Extreme lateral interbody fusion (XLIF) with supplemented instrumentation is a safe method for surgical therapy of spinal canal stenosis and spondylodiscitis with segmental scoliosis and bilateral neuroforamen stenosis.