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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Indirect decompression by ELIF – potential and limitations

Meeting Abstract

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  • Moritz Perrech - Uk Köln, Köln, Deutschland
  • Gernot Lang - Weill Cornell Medicine, Brain and Spine Center, New York, United States
  • Rodrigo Navarro-Ramirez - Weill Cornell Medicine, Brain and Spine Center, New York , United States
  • Roger Hartl - Weill Cornell Medicine, Brain and Spine Center, New York, United States
  • Roland Goldbrunner - Klinikum der Universität zu Köln, Zentrum für Neurochirurgie, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 134

doi: 10.3205/17dgnc697, urn:nbn:de:0183-17dgnc6976

Published: June 9, 2017

© 2017 Perrech et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Extreme lateral interbody fusion (ELIF) is a powerful tool for interbody fusion and coronal deformity correction. However, evidence regarding the success of ELIF in indirect decompression is lacking. The purpose of this study was to systematically review current literature on the potential and limitations of ELIF in indirect decompression and to identify factors influencing clinical and radiographic outcome.

Methods: A systematic literature search in the PubMed, Cochrane and ScienceDirect databases was performed. Radiographic and clinical outcome measures as well as information on study design, sample size, population, procedure, number and location of involved levels, follow-up time and complications was extracted and evaluated.

Results: 20 publications were selected for review including a total of 1080 patients. The majority of publications (90%) were retrospective case series. Most frequent indications for ELIF included degenerative disc disease, spinal stenosis, spondylolisthesis and degenerative scoliosis. Mean foraminal area and central canal area increased by 31.6mm2 and 28.5mm2, respectively. ELIF successfully improved foraminal stenosis, contradictory results were found for indirect decompression of central canal stenosis. Amount of indirect decompression seems to be independent from factors like cage position, side of approach or presence of facet degeneration.

Conclusion: Current data suggest ELIF to be an efficient technique in decompression of foraminal stenosis. Evidence on decompression of central canal is low and results are inconsistent. Based on literature predictive factors could not be identified, however, some evidence exists for cage diameter to be influential. Other factors were found to be non-influencing or data were insufficient.