Cristiano Magalhães Menezes1, Érica Godinho Menezes2, Jahangir Asghar3, Alfredo Guiroy3. 1. Columna Institute, Hospital Vila da Serra - Belo Horizonte, Nova Lima, Brazil cristiano@vertebral.com.br cristianomenezes@me.com. 2. Columna Institute, University Center of Belo Horizonte - UNIBH, Belo Horizonte, Brazil. 3. The Paley Orthopedic and Spine Institute at Saint Mary´s Medical Hospital, West Palm Beach, Florida, USA.
Abstract
OBJECTIVE: To perform a comprehensive review of the literature about the role of stand-alone lateral lumbar interbody fusion (LLIF). METHODS: A MEDLINE review was conducted including studies about stand-alone LLIF for any condition. The opinions of the authors were also considered. Studies that included biomechanical, cadaveric, or clinical aspects of stand-alone cages were revised to obtain data about the pros, cons, and limitations of the technique. Comparative studies with 360° (lateral + posterior) fusions were also analyzed. RESULTS: A total of 36 studies were identified. After reviewing the abstracts, 18 full articles of interest for the objective of this review were analyzed. Recommendations based on the literature were made. Although most of the recommendations in the literature were about augmentation with pedicle screws, there may be a role for stand-alone LLIF in some particular cases. Specific technical aspects should be considered to reduce the failure rate. CONCLUSION: Although there might be some specific indications for stand-alone LLIF, it should be considered an exception rather than the rule. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.
OBJECTIVE: To perform a comprehensive review of the literature about the role of stand-alone lateral lumbar interbody fusion (LLIF). METHODS: A MEDLINE review was conducted including studies about stand-alone LLIF for any condition. The opinions of the authors were also considered. Studies that included biomechanical, cadaveric, or clinical aspects of stand-alone cages were revised to obtain data about the pros, cons, and limitations of the technique. Comparative studies with 360° (lateral + posterior) fusions were also analyzed. RESULTS: A total of 36 studies were identified. After reviewing the abstracts, 18 full articles of interest for the objective of this review were analyzed. Recommendations based on the literature were made. Although most of the recommendations in the literature were about augmentation with pedicle screws, there may be a role for stand-alone LLIF in some particular cases. Specific technical aspects should be considered to reduce the failure rate. CONCLUSION: Although there might be some specific indications for stand-alone LLIF, it should be considered an exception rather than the rule. This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery.