Endoscope-assisted extreme-lateral interbody fusion (XLIF) - preliminary experience and technical note.

Endoscope-assisted extreme-lateral interbody fusion (XLIF) - preliminary experience and technical note.

World Neurosurg. 2017 Apr 26;:

Authors: Schonauer C, Stienen MN, Gautschi OP, Schaller K, Tessitore E

Abstract
BACKGROUND: The XLIF technique is safe and effective. The deep and tight surgical corridor, however, makes visual identification of important landmark structures as well as sufficient endplate and contralateral preparation challenging. The present analysis aims to assess the safety and feasibility of endoscope-assisted (EA-) extreme lateral lumbar interbody fusion (XLIF) procedures.
METHODS: Retrospective single-center study on consecutive patients undergoing XLIF procedures between 02/2014 and 07/2016. EA-XLIF and conventional (c-XLIF) procedures were compared regarding length of surgery (LOS), estimated blood loss (EBL), occurrence of peri- or postoperative complications and postoperative outcome.
RESULTS: A total of n=41 patients (mean age 66.7 years ± 10.0 standard deviation (SD); n=22 (53.7%) males) underwent a XLIF procedure, of which n=6 procedures were EA-XLIF (14.6%). EA-XLIF did not increase the LOS or EBL. There were no peri- or postoperative complications observed for any of the EA-XLIF procedures. Clinical and radiological outcomes at six weeks and last follow-up (FU, mean 8.0 months ± 5.8 SD) were similar for patients in the EA-XLIF or c-XLIF group. The EA-XLIF technique was considered particularly helpful for: a) checking the lumbar plexus anatomy on the psoas surface, b) identifying the relationship between the peritoneum and the psoas muscle, c) positioning the shim into the disc space d) removing the disk and e) checking the quality of contralateral release and endplate preparation.
CONCLUSIONS: The EA-XLIF technique is safe and might be considered as an adjunct as it improves visualization and can guide the surgeon in key steps of the XLIF procedure.

PMID: 28456736 [PubMed - as supplied by publisher]

http://ift.tt/2pxkimZ