Didier Recoules-Arche1, Claudia Druschel, Paul Fayada, Laurent Vinikoff, Alexander C Disch. 1. *Groupe Hospitalier du Havre, Hopital Jacques Monod, Montvilliers/Le Havre, France †Center for Musculoskeletal Surgery, Spine Surgery Unit, Campus Virchow, Charité-University Medicine Berlin, Berlin, Germany ‡Institut de l'Appareil Locomoteur Nollet, Paris et Polyclinique du Ternois, St Pol sur Ternoise §Clinique d´Alliance, Boulevard Alfred Nobel, Saint-Cyr-Sur-Loire, France.
Abstract
STUDY DESIGN: Description of the technique and retrospective study of patients treated with unilateral extraforaminal lumbar interbody fusion (ELIF) for degenerative lumbar spinal disorders. OBJECTIVE: To investigate clinical and radiologic outcome of patients treated with unilateral ELIF. SUMMARY OF BACKGROUND DATA: Lumbar interbody fusion is the classic treatment for higher grades of degenerative disk disease or lumbar segment instability and is performed by posterior (PLIF), posterolateral, or anterior (ALIF) approaches. Those techniques are well established with known limitations and complications. Today, minimally invasive procedures generate more interest especially in terms of muscle damage to achieve better functional outcome. We introduce a unilateral extraforaminal fusion technique which respects neural as well as muscle structures aiming to preserve function. METHODS: Intraoperative and perioperative data, neurological status, Oswestry Disability Index, the Visual Analogue Scale for leg and back pain, and patient satisfaction were investigated preoperatively and at latest follow-up. Fusion status was controlled by x-ray and CT scans at a 6 months' follow-up investigation. RESULTS: A total of 107 patients [female/male: 67/40; average age, 52.8 (± 13.8) y] were included at a maximum of 31(± 9.4) months. Complications occurred in 4% of patients. Transient radicular pain was investigated in 16 patients. The Oswestry Disability Index and the Visual Analogue Scale for back and leg pain improved significantly. Patients showed a short hospital stay and high percentage of return to work ratio (70%). Fusion was achieved in 97% of patients. CONCLUSIONS: The unilateral ELIF fusion technique demonstrates encouraging clinical and radiologic midterm outcome that for some indications is comparable with established fusion techniques.
STUDY DESIGN: Description of the technique and retrospective study of patients treated with unilateral extraforaminal lumbar interbody fusion (ELIF) for degenerative lumbar spinal disorders. OBJECTIVE: To investigate clinical and radiologic outcome of patients treated with unilateral ELIF. SUMMARY OF BACKGROUND DATA: Lumbar interbody fusion is the classic treatment for higher grades of degenerative disk disease or lumbar segment instability and is performed by posterior (PLIF), posterolateral, or anterior (ALIF) approaches. Those techniques are well established with known limitations and complications. Today, minimally invasive procedures generate more interest especially in terms of muscle damage to achieve better functional outcome. We introduce a unilateral extraforaminal fusion technique which respects neural as well as muscle structures aiming to preserve function. METHODS: Intraoperative and perioperative data, neurological status, Oswestry Disability Index, the Visual Analogue Scale for leg and back pain, and patient satisfaction were investigated preoperatively and at latest follow-up. Fusion status was controlled by x-ray and CT scans at a 6 months' follow-up investigation. RESULTS: A total of 107 patients [female/male: 67/40; average age, 52.8 (± 13.8) y] were included at a maximum of 31(± 9.4) months. Complications occurred in 4% of patients. Transient radicular pain was investigated in 16 patients. The Oswestry Disability Index and the Visual Analogue Scale for back and leg pain improved significantly. Patients showed a short hospital stay and high percentage of return to work ratio (70%). Fusion was achieved in 97% of patients. CONCLUSIONS: The unilateral ELIF fusion technique demonstrates encouraging clinical and radiologic midterm outcome that for some indications is comparable with established fusion techniques.