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Extreme lateral interbody fusion with posterior instrumentation for spondylodiscitis

, : Extreme lateral interbody fusion with posterior instrumentation for spondylodiscitis. Journal of Clinical Neuroscience 22(11): 1758-1761

The purpose of this study was to evaluate our initial experience utilizing extreme lateral interbody fusion (XLIF; NuVasive, San Diego, CA, USA) with percutaneous posterior instrumentation to treat 11 spondylodiscitis patients between January 2011 and February 2014. Although medical management is the first line treatment for spondylodiscitis, many patients fail antibiotic therapy and bracing, or present with instability, neurologic deficits, or sepsis, requiring operative debridement and stabilization. High rates of fusion and infection clearance have been reported with anterior lumbar interbody fusion (ALIF), but this approach requires a morbid exposure, associated with non-trivial rates of vascular and peritoneal complications. XLIF is an increasingly popular interbody fusion technique which utilizes a fast and minimally invasive approach, sparing the anterior longitudinal ligament, and allowing sufficient visualization of the intervertebral discs and bodies to debride and place a large, lordotic cage. The outcome measures for this study included lumbar lordosis, sagittal balance, subsidence, fusion, pain, neurological deficit, and microbiology/laboratory evidence of infection. The mean follow-up time was 9.3 months. All patients had improvements in pain and neurological symptoms. The mean lordosis change was 11.0°, from 23.1° preoperatively to 34.0° postoperatively. Fusion was confirmed with CT scans in five of six patients. At the last follow-up, all patients had normalization of inflammatory markers, no symptoms of infection, and none required repeat surgical treatment for spondylodiscitis. XLIF with percutaneous posterior instrumentation is a minimally invasive technique with reduced morbidity for lumbar spine fusion which affords adequate exposure to the vertebral bodies and discs to aggressively debride necrotic and infected tissue. This study suggests that XLIF may be a safe and effective alternative to ALIF for the treatment of spondylodiscitis.


PMID: 26138052

DOI: 10.1016/j.jocn.2015.05.021

Other references

Garg, P.P.; Diener-West, M.; Powe, N.R., 2001: Income-based disparities in outcomes for patients with chronic kidney disease. The impact of income on outcomes for patients with end-stage renal disease (ESRD), who are largely relieved of structural and financial barriers to care, is poorly understood. We conducted a prospective cohort study of 3,165 patients who developed...

Siwek, D.F.; Cipolloni, P.B.; Woerner, T.; Hearl, B., 1995: Confirmation of immunohistochemical reagent penetration in thick sections by 3D microscopy. Society for Neuroscience Abstracts 21(1-3): 1077

Mittendorf, E.A.; Chavez-MacGregor, M.; Vila, J.; Yi, M.; Lichtensztajn, D.Y.; Clarke, C.A.; Giordano, S.H.; Hunt, K.K., 2017: Bioscore: A Staging System for Breast Cancer Patients that Reflects the Prognostic Significance of Underlying Tumor Biology. Biologic factors guide treatment decisions and have a significant impact on prognosis for breast cancer patients. This study was undertaken to develop a staging system incorporating biologic factors in addition to standard anatomic factors in the...

Larsson S.; Lofdahl C G.; Arvidsson P.; Melander B.; Wahlander L.; Svedmyr N., 1988: Inhaled formoterol a beta 2 adrenoceptor agonist with long effect duration in a 2 week comparison with salbutamol studies of tachyphylaxis spray usage and symptom evaluation. European Respiratory Journal 1(SUPPL 2): 194S

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Mitchell, R.A.; Innes, J.F.; McNally, D., 2001: Pressure profilometry of the lumbosacral disk in dogs. This study was conducted to investigate the biomechanical behaviour of the 23 lumbosacral disk and adjacent vertebrae under compressive load in dogs, using pressure profilometry, and to investigate the relationship between pressure profile feature...

Reynolds, F.W., 1948: Penicillin in early syphilis; a statistical comparison of results from two studies. To determine causes for the discrepancies between results of the Venereal Disease Research Laboratory and those of the Central Statistical Unit in the penicillin treatment of early syphilis, a statistical comparison has been made. The factors whic...

Ansingkar, K.G.; Nanda, N.C.; Nekkanti, R.; Aaluri, S.R.; Mukhtar, O.P., 2001: Transesophageal three-dimensional color Doppler echocardiographic reconstruction of the left vertebral artery. We present a patient in whom we successfully reconstructed a long segment of the proximal left vertebral artery in three dimensions using color Doppler transesophageal echocardiography (TEE). Three-dimensional (3-D) color Doppler TEE may complemen...

Balter, M., 2015: ENERGY DEVELOPMENT. Big Archaeology fights Big Oil to preserve ancient landscape. Science 349(6250): 774-775

Nakagawa, M.; Tojo, K.; Sekijima, Y.; Yamazaki, K-hei.; Ikeda, S-ichi., 2012: Arterial thromboembolism in senile systemic amyloidosis: report of two cases. We describe a rare complication, systemic arterial thromboembolism, seen in two patients with senile systemic amyloidosis (SSA). Case 1 was a 73-year-old man who was tentatively diagnosed as having cardiac amyloidosis. Five months later, he was af...