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Extreme lateral interbody fusion for the treatment of adult degenerative scoliosis.

Publication ,  Journal Article
Caputo, AM; Michael, KW; Chapman, TM; Jennings, JM; Hubbard, EW; Isaacs, RE; Brown, CR
Published in: J Clin Neurosci
November 2013

Extreme lateral interbody fusion (XLIF; NuVasive Inc., San Diego, CA, USA) is a minimally invasive lateral transpsoas approach to the thoracolumbar spine. Though the procedure is rapidly increasing in popularity, limited data is available regarding its use in deformity surgery. We aimed to evaluate radiographic correction using XLIF in adults with degenerative lumbar scoliosis. Thirty consecutive patients were followed for an average of 14.3 months. Interbody fusion was completed using the XLIF technique with supplemental posterior instrumentation. Plain radiographs were obtained on all patients preoperatively, postoperatively, and at most recent follow-up. Plain radiographic measurements of coronal Cobb angle, apical vertebral translation, segmental lordosis, global lordosis, disc height, neuroforaminal height and neuroforaminal width were made at each time point. CT scans were obtained for all patients 1 year after surgery to evaluate for fusion. There was significant improvement in multiple radiographic parameters from preoperative to postoperative. Cobb angle corrected 72.3%, apical vertebral translation corrected 59.7%, neuroforaminal height increased 80.3%, neuroforaminal width increased 7.4%, and disc height increased 116.7%. Segmental lordosis at L4-L5 increased 14.1% and global lordosis increased 11.5%. There was no significant loss of correction from postoperative to most recent follow-up. There was an 11.8% pseudoarthrosis rate at levels treated with XLIF. Complications included lateral incisional hernia (n=1), rupture of anterior longitudinal ligament (n=2), wound breakdown (n=2), cardiac instability (n=1), pedicle fracture (n=1), and nonunion requiring revision (n=1). XLIF significantly improves coronal plane deformity in patients with adult degenerative scoliosis. XLIF has the ability to correct sagittal plane deformity, although it is most effective at lower lumbar levels.

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Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

November 2013

Volume

20

Issue

11

Start / End Page

1558 / 1563

Location

Scotland

Related Subject Headings

  • Treatment Outcome
  • Spine
  • Spinal Fusion
  • Scoliosis
  • Radiography
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intervertebral Disc Degeneration
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Caputo, A. M., Michael, K. W., Chapman, T. M., Jennings, J. M., Hubbard, E. W., Isaacs, R. E., & Brown, C. R. (2013). Extreme lateral interbody fusion for the treatment of adult degenerative scoliosis. J Clin Neurosci, 20(11), 1558–1563. https://doi.org/10.1016/j.jocn.2012.12.024
Caputo, Adam M., Keith W. Michael, Todd M. Chapman, Jason M. Jennings, Elizabeth W. Hubbard, Robert E. Isaacs, and Christopher R. Brown. “Extreme lateral interbody fusion for the treatment of adult degenerative scoliosis.J Clin Neurosci 20, no. 11 (November 2013): 1558–63. https://doi.org/10.1016/j.jocn.2012.12.024.
Caputo AM, Michael KW, Chapman TM, Jennings JM, Hubbard EW, Isaacs RE, et al. Extreme lateral interbody fusion for the treatment of adult degenerative scoliosis. J Clin Neurosci. 2013 Nov;20(11):1558–63.
Caputo, Adam M., et al. “Extreme lateral interbody fusion for the treatment of adult degenerative scoliosis.J Clin Neurosci, vol. 20, no. 11, Nov. 2013, pp. 1558–63. Pubmed, doi:10.1016/j.jocn.2012.12.024.
Caputo AM, Michael KW, Chapman TM, Jennings JM, Hubbard EW, Isaacs RE, Brown CR. Extreme lateral interbody fusion for the treatment of adult degenerative scoliosis. J Clin Neurosci. 2013 Nov;20(11):1558–1563.
Journal cover image

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

November 2013

Volume

20

Issue

11

Start / End Page

1558 / 1563

Location

Scotland

Related Subject Headings

  • Treatment Outcome
  • Spine
  • Spinal Fusion
  • Scoliosis
  • Radiography
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intervertebral Disc Degeneration
  • Humans