Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jun 21;10(2):286-294.
doi: 10.21037/jss-23-16. Epub 2024 May 14.

Lateral interbody fusion for adjacent segment disease: a narrative review

Christopher L Antonacci  1 , Francine Zeng  1 , Casey Jackson  1 , Ian J Wellington  1 , Seema M Patel  1 , Sean M Esmende  2
Affiliations
Review

Lateral interbody fusion for adjacent segment disease: a narrative review

Christopher L Antonacci et al. J Spine Surg. .

Abstract

Background and objective: Adjacent segment disease (ASD) is a late complication of lumbar fusion characterized by persistent symptoms correlating to radiographic changes in the levels immediately above or below the prior fusion. Lateral interbody fusion (LIF) through a direct lateral approach is a minimally invasive and effective surgical treatment for ASD. Biomechanically, LIF for ASD provides significantly decreased motion in multiple planes. While hardware failure and injury to the lumbar plexus are potential complications, these risks may be outweighed by decreased blood loss, shorter operating room (OR) times, and possibly superior patient reported visual analog scale (VAS) scores compared to traditional posterior spinal fusion (PSF) alone. The purpose of this review is to summarize the history, uses, outcomes, and future directions of LIF for ASD.

Methods: A review of national databases (PubMed and SCOPUS) was performed using literature from 1900 to 2022. Keywords included terms "LATERAL" and "LUMBAR" and "INTERBODY" and "FUSION" and "ADJACENT" and "SEGMENT" and "DISEASE". Studies that aimed to describe the biomechanical, clinical course and complications, radiological outcomes, biomechanical aspects, need for revision surgery, and/or patient reported outcomes of the XLIF/LIF technique were included.

Key content and findings: This review includes a brief overview of the natural history of ASD and current approaches to address it. It then summarizes the main indications and utilization of LIF to address ASD, summarizing reported outcomes in regard to biomechanical, clinical, and radiographic outcomes.

Conclusions: LIF has emerged as a minimally invasive and effective surgical treatment for ASD. This mini-review suggests that LIF provides a solid foundational biomechanical construct that has been paired with good patient-reported, clinical, and radiographic outcomes. While further research is required, current literature suggests that LIF for ASD results in fewer complications, decreased morbidity, and decreased need for subsequent surgery compared to other commonly utilized techniques.

Keywords: Lateral; adjacent; fusion; interbody; segment.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jss.amegroups.com/article/view/10.21037/jss-23-16/coif). The series “Minimally Invasive Techniques in Spine Surgery and Trend Toward Ambulatory Surgery” was commissioned by the editorial office without any funding or sponsorship. S.M.E. reports consulting fee and research support from Nuvasive. The authors have no other conflicts of interest to declare.

References

    1. Bono CM, Lee CK. Critical analysis of trends in fusion for degenerative disc disease over the past 20 years: influence of technique on fusion rate and clinical outcome. Spine (Phila Pa 1976) 2004;29:455-63; discussion Z5. 10.1097/01.BRS.0000090825.94611.28 - DOI - PubMed
    1. Rajaee SS, Bae HW, Kanim LE, et al. Spinal fusion in the United States: analysis of trends from 1998 to 2008. Spine (Phila Pa 1976) 2012;37:67-76. 10.1097/BRS.0b013e31820cccfb - DOI - PubMed
    1. Martin BI, Mirza SK, Spina N, et al. Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015. Spine (Phila Pa 1976) 2019;44:369-76. 10.1097/BRS.0000000000002822 - DOI - PubMed
    1. Irmola TM, Häkkinen A, Järvenpää S, et al. Reoperation Rates Following Instrumented Lumbar Spine Fusion. Spine (Phila Pa 1976) 2018;43:295-301. 10.1097/BRS.0000000000002291 - DOI - PubMed
    1. Anderson PA, Andersson GB, Arnold PM, et al. Terminology. Spine (Phila Pa 1976) 2012;37:S8-9. 10.1097/BRS.0b013e31826d62ed - DOI - PubMed

LinkOut - more resources