Department of Neurosurgery, University of Marburg, Marburg, Germany.
Department of Neurosurgery, University of Marburg, Marburg, Germany; Marburg Center for Mind, Brain and Behavior (MCMBB) Marburg, Germany.
Bosn J Basic Med Sci. 2021 Oct 1;21(5):587-597. doi: 10.17305/bjbms.2020.5261.
Extreme lateral interbody fusion (XLIF) has become the standard of minimally invasive lumbar segmental scoliosis treatment. Our objective is to determine the safety and efficacy of XLIF in spinal canal stenosis (SCS) and spondylodiscitis (SD). Patients treated with XLIF in our department between 2012 and 2018 were retrospectively analyzed. Patient records with clinical and radiographical parameters were evaluated. The patient cohort consists of 40 male and 32 female patients with a median age of 66.6 years. Forty-five patients had an SCS and 27 patients SD. The mean follow-up was 23 months. One level XLIF was performed in 49 patients, 2 levels in 15, 3 levels in 7 patients and 4 levels in 1 patient. All but one patient received an additional dorsal stabilization. The pain was present in all patients with a mean Visual Analogue Scale (VAS) score of 8.8 vs. postoperative VAS of 2.8 (p<0.05). Preoperative neurological deficits were found in 44 patients. Only 6 patients had a neurological deterioration, 45 patients improved, and 21 patients remained unchanged. One patient experienced a perioperative complication. Non-fusion occurred in 8 cases. There were no outcome differences regarding pain and radiological outcome between patients with SCS and SD as well as between patients with one level vs. multilevel surgery. Baseline characteristics and the radiological outcome did not differ between the two groups. Patients with SD had a higher rate of worsening of neurological deficits following surgery, a higher rate of non-fusion, and a longer hospital stay. Patients with spinal canal stenosis SCS had a longer surgery time and more frequent adjacent segment disease.
极外侧椎间融合术（XLIF）已成为微创腰椎节段性脊柱侧凸治疗的标准。我们的目的是确定 XLIF 在椎管狭窄症（SCS）和椎间盘炎（SD）中的安全性和有效性。回顾性分析了 2012 年至 2018 年在我科接受 XLIF 治疗的患者。评估了具有临床和影像学参数的患者记录。患者队列由 40 名男性和 32 名女性组成，平均年龄为 66.6 岁。45 例患者患有 SCS，27 例患者患有 SD。平均随访时间为 23 个月。49 例患者行 1 个节段 XLIF，15 例患者行 2 个节段，7 例患者行 3 个节段，1 例患者行 4 个节段。除 1 例患者外，所有患者均接受了额外的后路稳定。所有患者均有疼痛，平均视觉模拟评分（VAS）为 8.8，术后 VAS 为 2.8（p<0.05）。术前发现 44 例患者存在神经功能缺损。仅 6 例患者出现神经恶化，45 例患者改善，21 例患者无变化。1 例患者发生围手术期并发症。8 例发生非融合。SCS 和 SD 患者以及单节段与多节段手术患者在疼痛和影像学结果方面无差异。两组患者的基线特征和影像学结果无差异。SD 患者术后神经功能缺损恶化、非融合发生率和住院时间较高。SCS 患者手术时间较长，相邻节段疾病较频繁。
