Data Inconclusive on Efficacy of Lateral Lumbar Interbody Fusion

Lateral lumbar interbody fusion is a relatively new procedure used just in the past decade or so. Because the results to date with it are mostly heterogeneous, more research needs to be done to determine if lateral access lumbar interbody fusion is truly effective in practice and in cost, experts claim.

“The optimal indication needs to be further outlined in the literature. The non-comparative data on degenerative scoliosis suggests that it is a reasonable approach,” said Thomas E. Mroz, M.D., of the Center for Spine Health, in Cleveland, Ohio.

According to Mroz, some complications related to the anatomy are associated with lateral lumbar interbody fusion (LLEF). For example, the frequency of lumbar plexus injuries is greater than with more conventional approaches and catastrophic complications can occur.

“We do need comparative data. This will help us outline and find indications and define the outcomes and determine if these kinds of procedures are cost effective,” Mroz said.

Mroz cited three studies that researched the outcomes of LLIF patients, and outlined the advantages of the technique and the possible complications that can result from the operation.

He said the clinical results show the Oswestry Disability Index, VAS, SF-36 PCS and MCS scores were all statistically significantly improved from the preoperative baseline and 86 percent of patients who underwent this type of surgery in one of the studies indicated they would have that type of surgery a second time.

However, in a retrospective study of 293 patients treated over 6 years many patients who underwent LLIF did not see a statistically significant decrease in sensor and motor deficits or thigh pain, according to Mroz.