Our Summary

This research paper discusses a surgical procedure called minimally invasive lateral transpsoas interbody fusion (LLIF), which is used to treat a spinal condition known as low grade lumbar degenerative spondylolisthesis. This newer surgical method is less invasive than traditional ones, and it avoids some of the complications associated with them. The researchers reviewed recent scientific literature on this topic, using a number of databases and specific search terms. They carefully considered each study’s design, outcomes, and results, and only included those that met their criteria.

In total, they analyzed information from eight studies, which included 308 patients. These patients were followed for a period ranging from about 6 to 24 months. The results showed that none of these patients experienced certain specific complications, such as durotomies or pseudarthrosis. Any neurological complications were temporary and did not cause permanent issues.

Patients’ scores on a measure of disability improved significantly, and the amount of slipping in their spines was reduced by about half. Additionally, almost 90% of patients in three of the studies said they were satisfied with the surgery and would be willing to have it again. Overall, this less invasive surgery seems to have positive outcomes and avoids some of the risks of more traditional surgeries. However, more research is needed to fully understand its role in treating this spinal condition.

FAQs

  1. What is minimally invasive lateral transpsoas interbody fusion (LLIF)?
  2. What are the benefits of minimally invasive LLIF compared to traditional surgical methods for treating low grade lumbar degenerative spondylolisthesis?
  3. What were the main findings from the studies analyzed in the research paper about LLIF?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumbar fusion is to carefully follow post-operative instructions, including restrictions on physical activity, proper wound care, and attending follow-up appointments. It is important to allow the fusion to properly heal in order to achieve the best possible outcome. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support the healing process and overall spinal health.

Suitable For

Patients who are typically recommended lumbar fusion are those who have low grade lumbar degenerative spondylolisthesis. These patients may have tried conservative treatments such as physical therapy, medications, and injections without success. They may have symptoms such as back pain, leg pain, numbness, and weakness that are not improving with non-surgical interventions. Additionally, patients who have instability in their spine, spinal stenosis, or degenerative disc disease may also be candidates for lumbar fusion surgery. It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if lumbar fusion is the best course of action for them.

Timeline

Before lumbar fusion:

  1. Patient experiences chronic back pain and/or leg pain, often due to conditions such as degenerative disc disease, spondylolisthesis, or spinal stenosis.
  2. Patient undergoes conservative treatments such as physical therapy, medications, injections, and possibly spinal decompression therapy.
  3. If conservative treatments are not successful in relieving symptoms, patient may be recommended for lumbar fusion surgery.
  4. Patient undergoes pre-operative evaluations, including imaging studies and consultation with the surgeon to discuss the procedure and potential risks.

After lumbar fusion:

  1. Patient undergoes minimally invasive lateral transpsoas interbody fusion (LLIF) surgery to treat low grade lumbar degenerative spondylolisthesis.
  2. Patients are followed for a period of 6 to 24 months to monitor outcomes and complications.
  3. Patients experience improvements in disability scores, reduction in spinal slipping, and temporary neurological complications that do not cause permanent issues.
  4. Almost 90% of patients report satisfaction with the surgery and would be willing to undergo it again.
  5. More research is needed to fully understand the role of LLIF in treating this spinal condition and its long-term outcomes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with lumbar fusion surgery?
  2. How long is the recovery process after lumbar fusion surgery?
  3. What type of physical therapy or rehabilitation will be needed after the surgery?
  4. How successful is lumbar fusion surgery in relieving pain and improving function?
  5. Are there alternative treatments to lumbar fusion that could be considered?
  6. What is the long-term outlook for patients who undergo lumbar fusion surgery?
  7. How do I prepare for lumbar fusion surgery, both physically and mentally?
  8. What are the specific steps involved in the minimally invasive lateral transpsoas interbody fusion (LLIF) procedure?
  9. How many surgeries of this type have you performed, and what is your success rate?
  10. Are there any lifestyle changes or precautions I should take after lumbar fusion surgery to prevent complications or future issues?

Reference

Authors: Goyal A, Kerezoudis P, Alvi MA, Goncalves S, Bydon M. Journal: Clin Neurol Neurosurg. 2018 Apr;167:122-128. doi: 10.1016/j.clineuro.2018.02.020. Epub 2018 Feb 16. PMID: 29476935