Clinical and Radiographic Outcomes of Lateral Interbody Fusion for Adjacent Segment Degeneration

• Authors: Siamak Yasmeh, University School of Medicine, California; James Bernatz, University of Wisconsin School of Medicine and Public Health; Eli Garrard, Emory University; Miranda Bice, University of Wisconsin, Madison; Seth K Williams, University of Wisconsin, Madison
• Journal Title: International Journal of Spine Surgery
• Volume: Volume 15, Number 1
• Publisher: Elsevier | 2021-02-26, Pages 74-81
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.14444/8010
• Subjects: Health Sciences, Rehabilitation and Therapy; Health Sciences, Public Health
• Keywords: lateral interbody; antepsoas; lumbar fusion; adjacent segment disease

Abstract

Study Design Retrospective cohort study. Objective Assessment of outcomes in patients undergoing lateral interbody fusion as part of the surgical treatment of adjacent segment deterioration after previous lumbar spine fusion. Methods Adult patients with previous lumbar posterior spinal fusion who presented with adjacent segment degeneration and stenosis refractory to nonoperative treatment and who underwent lateral lumbar interbody fusion were retrospectively analyzed. Clinical and radiographic outcomes were assessed and comparisons made between preoperative baseline and postoperative values. Results Thirty-six patients with symptomatic adjacent segment degeneration at 46 motion segments were included. Thirty (83.3%) of the 36 patients had complete relief of both preoperative lower extremity pain and back pain at the time of final follow-up. Six (16.7%) of the 36 patients had persistent pain, though in all 6 cases, the pain was less postoperatively than preoperatively. Oswestry Disability Index scores were improved significantly at final follow-up (P = .001). Compared with preoperative baseline parameters, initial and final postoperative radiographs had an increase in segmental lordosis (P < .001 and P < .001, respectively), increase in overall lumbar lordosis (P < .05 and P = .094, respectively), decrease in segmental coronal angulation (P = .63 and P < .01, respectively), decrease in overall coronal angulation (P = .063 and P = .009, respectively), and increase in intervertebral height (P < .001 and P < .001, respectively). Conclusion Lateral lumbar interbody fusion achieves favorable clinical and radiographic outcomes for the treatment of adjacent segment degeneration after previous lumbar fusion.