. 2022 Apr 5.
doi: 10.1227/ons.0000000000000162.
Online ahead of print.
Affiliations
Affiliation
- 1 Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian/Weill Cornell Medicine, New York, New York, USA.
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Sertac Kirnaz et al.
Oper Neurosurg (Hagerstown).
.
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. 2022 Apr 5.
doi: 10.1227/ons.0000000000000162.
Online ahead of print.
Affiliation
- 1 Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York-Presbyterian/Weill Cornell Medicine, New York, New York, USA.
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Abstract
Lateral lumbar interbody fusion (LLIF) has several advantages over the other fusion techniques; by allowing the placement of a larger implant, LLIF results in better indirect decompression and increased disk height, foraminal height, and cross-sectional area of the dural sac.1,2 However, one of the primary drawbacks of the LLIF has been the need for repositioning to perform posterior stabilization. Furthermore, patients with severe central and lateral recess stenosis were found to be prone to indirect decompression failure after the LLIF procedure.3 In this video, we demonstrate a step-by-step technique for intraoperative navigation-guided lateral single-position LLIF with pedicle screw instrumentation and minimally invasive tubular decompression. We present a case of a 64-year-old female patient with a history of low back pain which radiates to the buttocks and posterior legs to her knees. The patient was treated by a single-position LLIF with posterior pedicle screw fixation using a portable intraoperative computed tomography scanner (Airo, Brainlab AG), combined with 3-dimensional computer navigation and minimally invasive tubular decompression at the L3-4 level. The patient was discharged at postoperative day 1 with excellent long-term clinical outcomes. Patient consent was obtained before performing the procedure. The participants and any identifiable individuals consented to publication of his/her image.
Copyright © Congress of Neurological Surgeons 2022. All rights reserved.
References
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Lang G, Perrech M, Navarro-Ramirez R, et al. Potential and limitations of neural decompression in extreme lateral interbody fusion-a systematic review. World Neurosurg. 2017;101:99-113.
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Schmidt FA, Navarro-Ramirez R, Chang L, et al. Neural decompression in challenging cases: advantages and disadvantages. J Neurosurg Sci. 2019;63(5):541-547.
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Kirnaz S, Navarro-Ramirez R, Gu J, et al. Indirect decompression failure after lateral lumbar interbody fusion-reported failures and predictive factors: systematic review. Glob Spine J. 2020;10(2 suppl):8s-16s.
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