Usefulness of Lateral Lumbar Interbody Fusion Combined with Indirect Decompression for Degenerative Lumbar Spondylolisthesis: A Systematic Review
<i>Background and Objective:</i> The aim of this review was to analyze the existing literature and investigate the outcomes or complications of lateral lumbar interbody fusion (LLIF) combined with indirect decompression for degenerative lumbar spondylolisthesis (DS). <i>Materials a...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-03-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/58/4/492 |
| _version_ | 1797434437111119872 |
|---|---|
| author | Takuya Nikaido Shin-ichi Konno |
| author_facet | Takuya Nikaido Shin-ichi Konno |
| author_sort | Takuya Nikaido |
| collection | DOAJ |
| description | <i>Background and Objective:</i> The aim of this review was to analyze the existing literature and investigate the outcomes or complications of lateral lumbar interbody fusion (LLIF) combined with indirect decompression for degenerative lumbar spondylolisthesis (DS). <i>Materials and Methods:</i> A database search algorithm was used to query MEDLINE, COCHRANE, and EMBASE to identify the literature reporting LLIF with indirect decompression for DS between January 2010 and December 2021. Improvements in outcome measures and complication rates were pooled and tested for significance. <i>Results:</i> A total of 412 publications were assessed, and 12 studies satisfied the inclusion criteria after full review. The pooled data available in the included studies showed that 438 patients with lumbar spondylolisthesis (mean age 65.2 years; mean body mass index (BMI) 38.1 kg/m<sup>2</sup>) underwent LLIF. A total of 546 disc spaces were operated on. The most frequently treated levels were L4–L5 and L3–L4. Clinically, the average improvement was 32.5% in ODI, 46.3 mm in low back pain, and 48.3 mm in leg pain estimated from the studies included. SF-36 PCS improved by 51.5% and MCS improved by 19.5%. For radiological outcomes, a reduction in slippage was seen in 6.3%. Disc height increased by 55%, foraminal height increased by 21.1%, the foraminal area on the approach side increased by 21.9%, and on the opposite side it increased by 26.1%. The cross-sectional spinal canal area increased by 20.6% after surgery. Post-operative complications occurred in 5–40% of patients with thigh symptoms, such as anterior thigh numbness, dysesthesia, discomfort, pain, and sensory deficits. <i>Conclusions:</i> Indirect decompression by LLIF for DS is an effective method for improving pain and dysfunction with less surgical invasion. In addition, it has the effect of significantly improving disc height, foraminal height and area, and segmental lordosis on radiological outcomes compared to the posterior approach. |
| first_indexed | 2024-03-09T10:32:13Z |
| format | Article |
| id | doaj.art-92cd954f8a6a454bb74c94868604ad52 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T10:32:13Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-92cd954f8a6a454bb74c94868604ad522023-12-01T21:12:38ZengMDPI AGMedicina1010-660X1648-91442022-03-0158449210.3390/medicina58040492Usefulness of Lateral Lumbar Interbody Fusion Combined with Indirect Decompression for Degenerative Lumbar Spondylolisthesis: A Systematic ReviewTakuya Nikaido0Shin-ichi Konno1Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1 Hikari-gaoka, Fukushima City 960-1295, JapanDepartment of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1 Hikari-gaoka, Fukushima City 960-1295, Japan<i>Background and Objective:</i> The aim of this review was to analyze the existing literature and investigate the outcomes or complications of lateral lumbar interbody fusion (LLIF) combined with indirect decompression for degenerative lumbar spondylolisthesis (DS). <i>Materials and Methods:</i> A database search algorithm was used to query MEDLINE, COCHRANE, and EMBASE to identify the literature reporting LLIF with indirect decompression for DS between January 2010 and December 2021. Improvements in outcome measures and complication rates were pooled and tested for significance. <i>Results:</i> A total of 412 publications were assessed, and 12 studies satisfied the inclusion criteria after full review. The pooled data available in the included studies showed that 438 patients with lumbar spondylolisthesis (mean age 65.2 years; mean body mass index (BMI) 38.1 kg/m<sup>2</sup>) underwent LLIF. A total of 546 disc spaces were operated on. The most frequently treated levels were L4–L5 and L3–L4. Clinically, the average improvement was 32.5% in ODI, 46.3 mm in low back pain, and 48.3 mm in leg pain estimated from the studies included. SF-36 PCS improved by 51.5% and MCS improved by 19.5%. For radiological outcomes, a reduction in slippage was seen in 6.3%. Disc height increased by 55%, foraminal height increased by 21.1%, the foraminal area on the approach side increased by 21.9%, and on the opposite side it increased by 26.1%. The cross-sectional spinal canal area increased by 20.6% after surgery. Post-operative complications occurred in 5–40% of patients with thigh symptoms, such as anterior thigh numbness, dysesthesia, discomfort, pain, and sensory deficits. <i>Conclusions:</i> Indirect decompression by LLIF for DS is an effective method for improving pain and dysfunction with less surgical invasion. In addition, it has the effect of significantly improving disc height, foraminal height and area, and segmental lordosis on radiological outcomes compared to the posterior approach.https://www.mdpi.com/1648-9144/58/4/492degenerative lumbar spondylolisthesis (DS)minimally invasive spine surgery (MISS)minimally invasive spinal stabilization (MISt)lateral lumbar interbody fusion (LLIF)percutaneous pedicle screw (PPS)indirect decompression |
| spellingShingle | Takuya Nikaido Shin-ichi Konno Usefulness of Lateral Lumbar Interbody Fusion Combined with Indirect Decompression for Degenerative Lumbar Spondylolisthesis: A Systematic Review Medicina degenerative lumbar spondylolisthesis (DS) minimally invasive spine surgery (MISS) minimally invasive spinal stabilization (MISt) lateral lumbar interbody fusion (LLIF) percutaneous pedicle screw (PPS) indirect decompression |
| title | Usefulness of Lateral Lumbar Interbody Fusion Combined with Indirect Decompression for Degenerative Lumbar Spondylolisthesis: A Systematic Review |
| title_full | Usefulness of Lateral Lumbar Interbody Fusion Combined with Indirect Decompression for Degenerative Lumbar Spondylolisthesis: A Systematic Review |
| title_fullStr | Usefulness of Lateral Lumbar Interbody Fusion Combined with Indirect Decompression for Degenerative Lumbar Spondylolisthesis: A Systematic Review |
| title_full_unstemmed | Usefulness of Lateral Lumbar Interbody Fusion Combined with Indirect Decompression for Degenerative Lumbar Spondylolisthesis: A Systematic Review |
| title_short | Usefulness of Lateral Lumbar Interbody Fusion Combined with Indirect Decompression for Degenerative Lumbar Spondylolisthesis: A Systematic Review |
| title_sort | usefulness of lateral lumbar interbody fusion combined with indirect decompression for degenerative lumbar spondylolisthesis a systematic review |
| topic | degenerative lumbar spondylolisthesis (DS) minimally invasive spine surgery (MISS) minimally invasive spinal stabilization (MISt) lateral lumbar interbody fusion (LLIF) percutaneous pedicle screw (PPS) indirect decompression |
| url | https://www.mdpi.com/1648-9144/58/4/492 |
| work_keys_str_mv | AT takuyanikaido usefulnessoflaterallumbarinterbodyfusioncombinedwithindirectdecompressionfordegenerativelumbarspondylolisthesisasystematicreview AT shinichikonno usefulnessoflaterallumbarinterbodyfusioncombinedwithindirectdecompressionfordegenerativelumbarspondylolisthesisasystematicreview |