Radiographic Results Following Lateral Lumbar Interbody Fusion (LLIF) and Indirect Decompression of Severe Spinal Stenosis
Michael R Murray, MD*
Main Line Healthcare, Pennsylvania, USA.
Received: January 20, 2022 Published: February 01, 2022
Abstract
Introduction: Prior studies have demonstrated the extent of indirect decompression that occurs following lateral lumbar interbody fusion (LLIF) within the immediate post-operative period. There have been conflicting reports on the ability of LLIF to adequately decompress severe central canal stenosis. This study provides data regarding the extent of indirect decompression that occurs with long term follow up (>6 months), in the setting of severe pre-operative spinal stenosis.
Methods: The retrospective case series reviewed 10 consecutive patients (11 spinal levels, limited to L3-L4 and L4-L5 segments) with severe (Schizas C or D) spinal stenosis that underwent LLIF with posterior instrumentation but without direct decompression. Each patient had an incidental post-operative MRI of the lumbar spine at least 6 months from the index procedure. Pre- and post-operative axial T2 MRI images were reviewed and the qualitative (Schizas) and quantitative (DSCA) degree of spinal stenosis were analyzed.
Results: All of the examined patients demonstrated a transition from severe (Schizas C or D) pre-operative stenosis to minimal or no spinal stenosis (Schizas A). There was an average pre- to post-operative increase in DSCA of 133.6% (SD +/- 54.5%) at an average of 13.0 months (SD +/-3.5 mo) following lateral lumbar interbody fusion, posterior instrumentation and indirect decompression.
Results: All of the examined patients demonstrated a transition from severe (Schizas C or D) pre-operative stenosis to minimal or no spinal stenosis (Schizas A). There was an average pre- to post-operative increase in DSCA of 133.6% (SD +/- 54.5%) at an average of 13.0 months (SD +/-3.5 mo) following lateral lumbar interbody fusion, posterior instrumentation and indirect decompression.
Keywords: Indirect Decompression; Spinal Stenosis; Lateral Lumbar Interbody Fusion; LLIF; XLIF
Citation: Murray MR. “Radiographic Results Following Lateral Lumbar Interbody Fusion (LLIF) and Indirect Decompression of Severe Spinal Stenosis”. SVOA Orthopaedics 2:1 (2022) Pages 19-24.