Lateral lumbar interbody fusion at L4-L5 has a low rate of complications in appropriately selected patients when using a standardized surgical technique.

Aims: The aim of this study was to reassess the rate of neurological, psoas-related, and abdominal complications associated with L4-L5 lateral lumbar interbody fusion (LLIF) undertaken using a standardized preoperative assessment and surgical technique.

Methods: This was a multicentre retrospective study involving consecutively enrolled patients who underwent L4-L5 LLIF by seven surgeons at seven institutions in three countries over a five-year period. The demographic details of the patients and the details of the surgery, reoperations and complications, including femoral and non-femoral neuropraxia, thigh pain, weakness of hip flexion, and abdominal complications, were analyzed.

Single-Position Prone Lateral Lumbar Interbody Fusion Increases Operative Efficiency and Maintains Safety in Revision Lumbar Spinal Fusion.

Study Design: Multi-centre retrospective cohort study.

Objective: To evaluate the feasibility and safety of the single-position prone lateral lumbar interbody fusion (LLIF) technique for revision lumbar fusion surgery.

Background Context: Prone LLIF (P-LLIF) is a novel technique allowing for placement of a lateral interbody in the prone position and allowing posterior decompression and revision of posterior instrumentation without patient repositioning.

Lateral decubitus single position anterior posterior surgery improves operative efficiency, improves perioperative outcomes, and maintains radiological outcomes comparable with traditional anterior posterior fusion at minimum 2-year follow-up.

Background Context: The advantages of lateral single position surgery (LSPS) in the perioperative period has previously been demonstrated, however 2-year postoperative outcomes of this novel technique have not yet been compared to circumferential anterior-posterior fusion (FLIP) at 2-years postoperatively.

Purpose: Evaluate the safety and efficacy of LSPS versus gold-standard FLIP STUDY DESIGN/SETTING: Multicenter retrospective cohort review.

Patient Sample: Four hundred forty-two patients undergoing lumbar fusion via LSPS or FLIP OUTCOME MEASURES: Levels fused, operative time, estimated blood loss, perioperative complications, and reasons for reoperation at 30-days, 90-days, 1-year, and 2-years.

Single-position circumferential lumbar spinal fusion: an overview of terminology, concepts, rationale and the current evidence base.

Purpose: To provide definitions and a conceptual framework for single position surgery (SPS) applied to circumferential fusion of the lumbar spine.

Methods: Narrative literature review and experts' opinion.

Results: Two major limitations of lateral lumbar interbody fusion (LLIF) have been (a) a perceived need to reposition the patient to the prone position for posterior fixation, and (b) the lack of a robust solution for fusion at the L5/S1 level.

Postoperative spinal alignment comparison of lateral versus supine patient position L5-S1 anterior lumbar interbody fusion.

Purpose: Over the past decade, alternative patient positions for the treatment of the anterior lumbar spine have been explored in an effort to maximize the benefits of direct anterior column access while minimizing the inefficiencies of single or multiple intraoperative patient repositionings. The lateral technique allows for access from L1 to L5 through a retroperitoneal, muscle-splitting, transpsoas approach with placement of a large intervertebral spacer than can reliably improve segmental lordosis, though its inability to be used at L5-S1 limits its overall adoption, as L5-S1 is one of the most common levels treated and where high levels of lordosis are optimal. Recent developments in instrumentation and techniques for lateral-position treatment of the L5-S1 level with a modified anterior lumbar interbody fusion (ALIF) approach have expanded the lateral position to L5-S1, though the positional effect on L5-S1 lordosis is heretofore unreported.

Spinal exposure for anterior lumbar interbody fusion (ALIF) in the lateral decubitus position: anatomical and technical considerations.

Purpose: Single position surgery has demonstrated to reduce hospital length of stay, operative times, blood loss, postoperative pain, ileus, and complications. ALIF and LLIF surgeries offer advantages of placing large interbody devices under direct compression and can be performed by a minimally invasive approach in the lateral position. Furthermore, simultaneous access to the anterior and posterior column is possible in the lateral position without the need for patient repositioning.

Lateral decubitus single position anterior-posterior (AP) fusion shows equivalent results to minimally invasive transforaminal lumbar interbody fusion at one-year follow-up.

Purpose: This study compares perioperative and 1-year outcomes of lateral decubitus single position circumferential fusion (L-SPS) versus minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) for degenerative pathologies.

Methods: Multicenter retrospective chart review of patients undergoing AP fusion with L-SPS or MIS TLIF. Demographics and clinical and radiographic outcomes were compared using independent samples t tests and chi-squared analyses with significance set at p < 0.

Anterior column reconstruction of the lumbar spine in the lateral decubitus position: anatomical and patient-related considerations for ALIF, anterior-to-psoas, and transpsoas LLIF approaches.

Purpose: Circumferential (AP) lumbar fusion surgery is an effective treatment for degenerative and deformity conditions of the spine. The lateral decubitus position allows for simultaneous access to the anterior and posterior aspects of the spine, enabling instrumentation of both columns without the need for patient repositioning. This paper seeks to outline the anatomical and patient-related considerations in anterior column reconstruction of the lumbar spine from L1-S1 in the lateral decubitus position.

Single position lateral decubitus anterior lumbar interbody fusion (ALIF) and posterior fusion reduces complications and improves perioperative outcomes compared with traditional anterior-posterior lumbar fusion.

Background Context: Lateral decubitus single position anterior-posterior (AP) fusion utilizing anterior lumbar interbody fusion and percutaneous posterior fixation is a novel, minimally invasive surgical technique. Single position lumbar surgery (SPLS) with anterior lumbar interbody fusion (ALIF) or lateral lumbar interbody fusion (LLIF) has been shown to be a safe, effective technique. This study directly compares perioperative outcomes of SPLS with lateral ALIF vs.

Applied anatomy and surgical technique of the lateral single-position L5-S1 fusion.

The latest development in the anterior lumbar interbody fusion (ALIF) procedure is its application in the lateral position to allow for simultaneous posterior percutaneous screw placement. The technical details of the lateral ALIF technique have not yet been described. To describe the surgical anatomy relevant to the lateral ALIF approach we performed a comprehensive anatomical study.

Rate of failure of indirect decompression in lateral single-position surgery: clinical results.

Objective: Lateral single-position surgery (LSPS) of the lumbar spine generally involves anterior lumbar interbody fusion (ALIF) performed in the lateral position (LALIF) at L5-S1 with or without lateral lumbar interbody fusion (LLIF) at L4-5 and above, followed by bilateral pedicle screw fixation (PSF) without repositioning the patient. One obstacle to more widespread adoption of LSPS is the perceived need for direct decompression of the neural elements, which typically requires flipping the patient to the prone position. The purpose of this study was to examine the rate of failure of indirect decompression in a cohort of patients undergoing LSPS from L4 to S1.

The Evaluation of Donor Site Pain After Harvest of Tricortical Anterior Iliac Crest Bone Graft for Spinal Surgery: A Prospective Study.

Study Design: A prospective cohort.

Objective: The aim of this study was to prospectively observe donor site pain, health-related quality-of-life outcomes, and complications following harvest of tricortical anterior iliac crest bone graft (AICBG) for anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Persistent donor site pain from the anterior iliac crest has been reported to range between 2% and 40%.

Posterolateral Lumbar Arthrodesis With and Without Interbody Arthrodesis for L4-L5 Degenerative Spondylolisthesis: A Comparative Value Analysis.

Study Design: Independent retrospective review of prospectively collected data, comparative cohort study.

Objective: The objective of this study was to compare the clinical, radiographical, and cost/value of the addition of an interbody arthrodesis (IBA) to a posterolateral arthrodesis (PLA) in the surgical treatment of L4-L5 degenerative spondylolisthesis (DS). The authors hypothesized that the addition of IBA to PLA would produce added value while incurring minimal additional costs.

Mortality in elderly patients following operative and nonoperative management of odontoid fractures.

Study Design: Retrospective matched cohort study.

Objective: To compare mortality in elderly patients with odontoid fractures after operative and nonoperative treatment. In addition, to evaluate potential factors that may increase the risk of mortality in the geriatric population after odontoid fracture.

Congenital stenosis and adjacent segment disease in the cervical spine.

Symptomatic adjacent segment disease (ASD) after anterior cervical fusion (ACF) is reported in 25% of patients at 10 years postoperatively. Debate continues as to whether this degeneration is due to the natural history of the disk or the changed biomechanics after ACF. This study explored whether congenital stenosis predisposes patients to an increased incidence of ASD after ACF.

Operative treatment of cervical myelopathy: cervical laminoplasty.

Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method.

Clinical indications for arterial imaging in cervical trauma.

Study Design: A retrospective cohort study.

Objective: To evaluate the clinical indications for acquiring arterial imaging in cervical trauma.

Summary Of Background Data: Cervical spine injuries are very common in high-energy trauma and are frequently seen at Level I trauma centers across the country.

Does smoking influence fusion rates in posterior cervical arthrodesis with lateral mass instrumentation?

Background: Smoking is associated with reduced fusion rates after anterior cervical decompression and arthrodesis procedures. Posterior cervical arthrodesis procedures are believed to have a higher fusion rate than anterior procedures.

Questions/purposes: We asked whether smoking (1) would reduce the fusion rate in posterior cervical procedures; and (2) be associated with increased pain, decreased activity level, and a decreased rate of return of work as compared with nonsmokers.

Anatomic and structural evaluation of the hip: a cross-sectional imaging technique combining anatomic and biomechanical evaluations.

To describe a technique of cross-sectional imaging of the adult hip designed to evaluate for anatomic anomalies that may predispose to internal derangement in addition to the routine anatomic assessment. Magnetic resonance (MR) imaging, MR arthrography, and multidetector computed tomography (MDCT) scanning protocols utilize high-resolution imaging, and the surrounding anatomy is also assessed using these scanning techniques. Various measurements may be obtained to assess the overarching anatomic configuration including the caput caput collum diaphysis angle, the femoral angle of torsion, the acetabular angle of torsion, the center edge angle, and the femur length.

The function of the hip capsular ligaments: a quantitative report.

Purpose: Our purpose was to analyze the anatomy and quantitative contributions of the hip capsular ligaments.

Methods: The stabilizing roles of the medial and lateral arms of the iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament were examined in 12 matched pairs of fresh-frozen cadaveric hips (6 male and 6 female hips). The motion at the hip joint was measured in internal and external rotation through ranges of motion from 30 degrees flexion to 10 degrees extension along a neutral swing path.

Clinical examination of the athletic hip.

This article provides a succinct and complete method for the clinical evaluation of the hip. Included are descriptions of examination tests as well as their relationships to possible pathology of the hip. The examination is divided into five stages: seated, standing, supine, lateral, and prone; with a total of 11 assessment points.