Stienen Martin N, Fischer Gregor, Bättig Linda, Veeravagu Anand, Martens Benjamin
Spine Center of Eastern Switzerland, Cantonal Hospital of St. Gallen & Medical School of St. Gallen, St. Gallen, Switzerland.
Department of Neurosurgery, Cantonal Hospital of St. Gallen & Medical School of St. Gallen, St. Gallen, Switzerland.
Brain Spine. 2024 Jul 15;4:102870. doi: 10.1016/j.bas.2024.102870. eCollection 2024.
Reports about lateral lumbar or thoracic interbody fusion (LLIF) using expandable interbody spacers are sparse.
To report our experience with the use of expandable spacers for LLIF.
We reviewed all consecutive LLIF patients with use of an expandable titanium interbody implant (ELSA® Expandable Integrated LLIF Spacer, Globus Medical Inc, PA (USA)) between September 2018 and January 2024.
We identified 503 patients, in which we performed LLIF at 732 levels. In 63 patients (12.5%) and 70 levels (9.6%) an expandable spacer was used. The mean age was 61.4 years, 57.1% were females. LLIF was performed between T11/12 - L4/5 in the setting of fusion procedures (mono-/bisegmental (20; 28.6%), 3-7 segments (29; 41.4%); >7 segments (21; 30.0%)), of which 21 (33.3%), 20 (31.8%) and 22 (34.9%) were for traumatic, deformity/revision and other diagnoses. Surgery included release of the anterior longitudinal ligament in 30 cases (42.9%). Intraoperative adverse events (AEs) were noted in 2 (3.2%), postoperative AEs in 27 (42.9%) at discharge, 17 (27.0%) at 3 months and 14 (22.2%) at 12 months. Segmental sagittal Cobb angle changed from 1.3° (preoperative) to 13.0° at discharge (p < 0.001), 12.7° at 3 months (p < 0.001) and 13.3° at 12 months (p < 0.001). Functional outcome was excellent/good in 43 (68.3%; 5 missing) at 3 months and in 37 (58.7%; 10 missing) at 12 months.
The use of LLIF with an expandable spacer was safe, promoted solid fusion and enabled powerful correction of sagittal segmental Cobb angle, which was maintained during follow-up.
关于使用可扩张椎间融合器进行腰椎或胸椎外侧椎间融合术（LLIF）的报道较少。
报告我们使用可扩张融合器进行LLIF的经验。
我们回顾了2018年9月至2024年1月期间所有连续使用可扩张钛制椎间植入物（ELSA®可扩张一体式LLIF融合器，美国宾夕法尼亚州的Globus Medical公司）进行LLIF手术的患者。
我们确定了503例患者，共进行了732节段的LLIF手术。其中63例患者（12.5%）和70节段（9.6%）使用了可扩张融合器。患者平均年龄为61.4岁，女性占57.1%。LLIF手术在T11/12至L4/5节段进行，用于融合手术（单节段/双节段（20例；28.6%），3 - 7节段（29例；41.4%）；>7节段（21例；30.0%）），其中21例（33.3%）、20例（31.8%）和22例（34.9%）分别用于创伤、畸形/翻修和其他诊断。手术包括30例（42.9%）患者的前纵韧带松解。术中不良事件（AE）发生2例（3.2%），术后出院时发生27例（42.9%），3个月时发生17例（27.0%），12个月时发生14例（22.2%）。节段矢状面Cobb角从术前的1.3°出院时变为13.0°（p < 0.001），3个月时为12.7°（p < 0.001），12个月时为13.3°（p < 0.001）。3个月时功能结果为优/良的有43例（68.3%；5例失访），12个月时为37例（58.7%；10例失访）。
使用可扩张融合器进行LLIF手术是安全的，促进了牢固融合，并能有效矫正矢状面节段Cobb角，且在随访期间得以维持。
