Extreme lateral approach to the spine in degenerative and post traumatic lumbar diseases: selection process, results and complications

Abstract

Purpose of the study: The aim of this study is to describe clinical and radiological outcomes as well as accompanying complications in a series of consecutive lateral transpsoas approaches (XLIF).

Materials and methods: A retrospective study of 39 patients treated for degenerative and post-traumatic lumbar diseases was carried out. Functional status, leg and back pain and radiological outcomes were evaluated pre and post-operatively using the Oswestry disability index score (ODI) visual analog scales (VAS) and X-ray studies.

Results: Mean follow-up was 16 months (range 12-24 months). Mean improvement in back and leg pain on VAS was 6.08 (p < 0.01) and 2.77 (p < 0.01), respectively. Mean improvement in the ODI score was 38 (p < 0.01). Increases in lumbar lordosis (32.8°-39.2°, p < 0.05) and disc height (3.6-4.8 mm, p < 0.05) were noted in the post-operative. Mild, transient strength deficit of the quadriceps muscle was also noted in ten cases with complete regression.

Conclusions: XLIF proved to be a safe, effective, minimally invasive technique that allows valid arthrodesis to be carried out. Patients achieved positive clinical outcomes and satisfactory fusion rates, with sustained restoration of lordosis, spinal alignment and disc height.