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Extreme Lateral Interbody Fusion (XLIF) with Lateral Modular Plate Fixation: Preliminary Report on Clinical and Radiological Outcomes

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The Funnel: From the Skull Base to the Sacrum

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 135))

Abstract

The lateral transpsoas approach (extreme lateral interbody fusion, or XLIF) allows surgeons to use various lordotic cage sizes to help restore intervertebral disk height, correct sagittal alignment, and improve fusion rates. The use of standalone devices has consistently raised doubts due to the high risk of complications and inadequate functional recovery that a circumferential arthrodesis can support. The recent introduction of a novel XLIF cage with adapted lateral plate fixation (XLPF) may further enhance the structural rigidity, consolidating the cage and plate into a singular modular entity. Nine patients from our surgical centers underwent a procedure of 1-level XLIF with XLPF in selected cases. We observed that XLPF does not extend the intraoperative footprint and provides immediate rigidity to the anterior column without any additional risk of complications and with minimal increased time compared to the traditional cage implant procedure. Although it has been shown that the use of interbody fusion cages with supplemental posterior fixation improves stabilization in all directions, the technique of standalone lateral cages may also have a place in spine surgery in that the stability may be sufficient in selected cases, such as junctional syndrome and in some forms of degenerative scoliosis.

The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript. The authors confirm their adherence to ethical standards and have no financial disclosures that would be potential conflicts of interest with this publication.

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Abbreviations

ALIF:

Anterior lumbar interbody fusions

MISS:

Minimally invasive spine surgery

PLF:

Posterolateral lumbar fusion

PLIF:

Posterior lumbar interbody fusion

TLIF:

Transforaminal lumbar interbody fusion

XLIF:

Extreme lateral interbody fusion

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Authors and Affiliations

  1. Neurosurgery Division, Human Neurosciences Department, “Sapienza” University, Rome (RM), Italy

    Daniele Armocida, Umberto Aldo Arcidiacono, Antonio Santoro & Alessandro Frati

  2. Division of Spinal Surgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy

    Andrea Perna, Luca Proietti & Francesco Ciro Tamburrelli

  3. Spine Surgery Unit–Humanitas Gradenigo, Torino, Italy

    Fabio Cofano

  4. Department of Neuroscience, “Rita Levi Montalcini,” University of Torino, Torino, Italy

    Fabio Cofano & Diego Garbossa

  5. Unit of Neurosurgery, Sant’Andrea Hospital, Rome, Italy

    Marco Cimatti

  6. Unit of Neurosurgery, AOU Città della Salute e della Scienza, Torino, Italy

    Nicola Marengo, Marco Ajello & Diego Garbossa

  7. Institute of Orthopaedic, Università Cattolica del Sacro Cuore, Rome, Italy

    Luca Proietti & Francesco Ciro Tamburrelli

  8. Shoulder Unit Villa Stuart Clinic (Rome), Shoulder-Knee Unit PIO XI Clinic (Rome), Rome, Italy

    Marco Maiotti

  9. IRCCS “Neuromed”, Pozzilli (IS), Italy

    Alessandro Frati

Authors
  1. Daniele Armocida
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  2. Andrea Perna
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  3. Fabio Cofano
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  4. Marco Cimatti
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  5. Umberto Aldo Arcidiacono
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  7. Marco Ajello
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  8. Diego Garbossa
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  9. Luca Proietti
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  10. Francesco Ciro Tamburrelli
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  11. Marco Maiotti
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  12. Antonio Santoro
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Editor information

Editors and Affiliations

  1. Institute of Neurosurgery, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

Ethics declarations

This study was not funded by any association.

Conflict of Interest

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We wish to draw the attention of the editor to the following facts, which may be considered as potential conflicts of interest, and to the significant financial contributions to this work.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study. The patients consented to the submission of this review chapter.

We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.

We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing, we confirm that we have followed the regulations of our institutions concerning intellectual property.

We further confirm that any aspect of the work covered in this manuscript that has involved either experimental animals or human patients has been conducted with the ethical approval of all relevant bodies and that such approvals are acknowledged within the manuscript.

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Armocida, D. et al. (2023). Extreme Lateral Interbody Fusion (XLIF) with Lateral Modular Plate Fixation: Preliminary Report on Clinical and Radiological Outcomes. In: Visocchi, M. (eds) The Funnel: From the Skull Base to the Sacrum. Acta Neurochirurgica Supplement, vol 135. Springer, Cham. https://doi.org/10.1007/978-3-031-36084-8_66

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  • DOI: https://doi.org/10.1007/978-3-031-36084-8_66

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36083-1

  • Online ISBN: 978-3-031-36084-8

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