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Extreme lateral approach to the spine in degenerative and post traumatic lumbar diseases: selection process, results and complications

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Abstract

Purpose of the study

The aim of this study is to describe clinical and radiological outcomes as well as accompanying complications in a series of consecutive lateral transpsoas approaches (XLIF).

Materials and methods

A retrospective study of 39 patients treated for degenerative and post-traumatic lumbar diseases was carried out. Functional status, leg and back pain and radiological outcomes were evaluated pre and post-operatively using the Oswestry disability index score (ODI) visual analog scales (VAS) and X-ray studies.

Results

Mean follow-up was 16 months (range 12–24 months). Mean improvement in back and leg pain on VAS was 6.08 (p < 0.01) and 2.77 (p < 0.01), respectively. Mean improvement in the ODI score was 38 (p < 0.01). Increases in lumbar lordosis (32.8°–39.2°, p < 0.05) and disc height (3.6–4.8 mm, p < 0.05) were noted in the post-operative. Mild, transient strength deficit of the quadriceps muscle was also noted in ten cases with complete regression.

Conclusions

XLIF proved to be a safe, effective, minimally invasive technique that allows valid arthrodesis to be carried out. Patients achieved positive clinical outcomes and satisfactory fusion rates, with sustained restoration of lordosis, spinal alignment and disc height.

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Conflict of interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Clinica Ortopedica, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, Largo Rosanna Benzi, 10, 16132, Genova, Italy

    Matteo Formica, Luca Cavagnaro & Andrea Zanirato

  2. U.O. Ortopedia e Traumatologia 1- Azienda Ospedaliero Universitaria Policlinico-Giovanni XXIII di Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy

    Andrea Piazzolla

  3. IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy

    Pedro Berjano & Carlo Formica

Authors
  1. Matteo Formica
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  2. Pedro Berjano
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  3. Luca Cavagnaro
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  4. Andrea Zanirato
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  5. Andrea Piazzolla
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  6. Carlo Formica
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Correspondence to Luca Cavagnaro.

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Formica, M., Berjano, P., Cavagnaro, L. et al. Extreme lateral approach to the spine in degenerative and post traumatic lumbar diseases: selection process, results and complications. Eur Spine J 23 (Suppl 6), 684–692 (2014). https://doi.org/10.1007/s00586-014-3545-y

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  • DOI: https://doi.org/10.1007/s00586-014-3545-y

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