Gernot Lang1, Moritz Perrech2, Rodrigo Navarro-Ramirez3, Ibrahim Hussain3, Brenton Pennicooke3, Farah Maryam3, Mauricio J Avila3, Roger Härtl4. 1. Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA; Department of Orthopedic and Trauma Surgery, Freiburg University Medical Center, Freiburg, Germany. 2. Department of Neurosurgery, University of Cologne, Cologne, Germany. 3. Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA. 4. Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA. Electronic address: roger@hartlmd.net.
Abstract
BACKGROUND: Extreme lateral interbody fusion (ELIF) is a powerful tool for interbody fusion and coronal deformity correction. However, evidence regarding the success of ELIF in decompressing foraminal, lateral recess, and central canal stenosis is lacking. We performed a systematic review of current literature on the potential and limitations of ELIF to indirectly decompress neural elements. METHODS: A literature search using PubMed, Cochrane, and ScienceDirect databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Information on study design, sample size, population, procedure, number and location of involved levels, follow-up time, and complications as well as information on conflict of interest was extracted and evaluated. RESULTS: We selected 20 publications including 1080 patients for review. Most publications (90%) were retrospective case series. Most frequent indications for ELIF included degenerative disc disease, spinal stenosis, spondylolisthesis, and degenerative scoliosis. Most studies revealed significant improvement in radiographic and clinical outcome after ELIF. Mean foraminal area, central canal area, and subarticular diameter increased by 31.6 mm2, 28.5 mm2, and 0.85 mm. ELIF successfully improved foraminal stenosis. Contradictory results were found for indirect decompression of central canal stenosis. Data on lateral recess stenosis were scarce. CONCLUSIONS: Current data suggest ELIF to be an efficient technique in decompression of foraminal stenosis. Evidence on decompression of central canal or lateral recess stenosis via ELIF is low, and results are inconsistent. Most studies are limited by study design, sample size, and potential conflicts of interest.
BACKGROUND: Extreme lateral interbody fusion (ELIF) is a powerful tool for interbody fusion and coronal deformity correction. However, evidence regarding the success of ELIF in decompressing foraminal, lateral recess, and central canal stenosis is lacking. We performed a systematic review of current literature on the potential and limitations of ELIF to indirectly decompress neural elements. METHODS: A literature search using PubMed, Cochrane, and ScienceDirect databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Information on study design, sample size, population, procedure, number and location of involved levels, follow-up time, and complications as well as information on conflict of interest was extracted and evaluated. RESULTS: We selected 20 publications including 1080 patients for review. Most publications (90%) were retrospective case series. Most frequent indications for ELIF included degenerative disc disease, spinal stenosis, spondylolisthesis, and degenerative scoliosis. Most studies revealed significant improvement in radiographic and clinical outcome after ELIF. Mean foraminal area, central canal area, and subarticular diameter increased by 31.6 mm2, 28.5 mm2, and 0.85 mm. ELIF successfully improved foraminal stenosis. Contradictory results were found for indirect decompression of central canal stenosis. Data on lateral recess stenosis were scarce. CONCLUSIONS: Current data suggest ELIF to be an efficient technique in decompression of foraminal stenosis. Evidence on decompression of central canal or lateral recess stenosis via ELIF is low, and results are inconsistent. Most studies are limited by study design, sample size, and potential conflicts of interest.
Authors: Thiago Pereira Coutinho; Alexandre Fogaça Cristante; Raphael Martus Marcon; Ivan Dias da Rocha; Allan Hiroshi Ono; Guilherme Pereira Correa Meyer; Tarcísio Eloy de Pessoa Barros Filho Journal: Global Spine J Date: 2019-07-26
Authors: Gernot Lang; Marco Vicari; Alexander Siller; Eva J Kubosch; Juergen Hennig; Norbert P Südkamp; Kaywan Izadpanah; David Kubosch Journal: Cureus Date: 2018-04-06
Authors: Sertac Kirnaz; Rodrigo Navarro-Ramirez; Jiaao Gu; Christoph Wipplinger; Ibrahim Hussain; Joshua Adjei; Eliana Kim; Franziska Anna Schmidt; Taylor Wong; Robert Nick Hernandez; Roger Härtl Journal: Global Spine J Date: 2020-05-28