Biblioteca Virtual en Salud

Objective To investigate the clinical outcomes of lateral lumbar interbody fusion (LLIF) in lumbar corpectomy and reconstruction.Methods Overall,8 patients with lumbar burst fracture and dislocation and 1 patient with postoperative infection of lumbar fracture who were treated with LLIF from May 2014 to May 2016 in our hospital were retrospective analyzed.The included 9 patients,with 8 males and 1 female,had an average age of 5.5±6.7 years (28-59 years).Among them,4 cases were injured at L2 segment,4 cases at L3,and 1 case at L4.The main symptoms were back pain and dysfunction of perineum and lower extremity caused by nerve injury.Preoperative neurological functions were assessed according to the American Spinal Injury Association's modified Frankel classification,with 1 case at Grade A,2 Grade B,3 Grade C,1 Grade D,and 2 Grade E.The operation time,the amount of intraoperative bleeding,and the length of hospital stay were recorded.The clinical outcomes were evaluated by the ASIA grading,visual analog scale (VAS),and Oswestry disability index (ODI).The changes of body temperature,erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP) before and after surgery were recorded for the patients with infection.The recovery of lumbar lordosis and the fusion of bone graft were evaluated by the radiographic examination of the lumbar spine and lumbar sagittal Cobb angle.Results The average operation time was 73± 12.7min,ranging from 50 to 90 min.The amount of intraoperative bleeding was 650±35.3 ml,with a range between 30 and 150 ml.All incisions were fully healed.The length of hospital stay was 5.0± 1.0 days,ranging from 4 to 7 days.All patients were followed up for 16.4±3.8 months (11-24 months).The VAS scores and ODI were improved significantly after surgery compared with pre-operation.For patients with infection,body temperature,ESR,and CRP went back to normal within 3,17,and 25 days after surgery,respectively.The ASIA improvement was observed in six patients,with one from grade A to C,one from grade B to D,one from grade B to E,one from grade C to D,one from grade C to E,and one from grad D to E.The lordosis of lumbar spine and surgical segments were restored significantly after surgery,with an increase by 19.9 and 5.1 degree,respectively.All the patients achieved bone fusion after operation.Hip weakness,thigh pain,numbness,retroperitoneal hematoma,and other complications were not observed in these patients.Conclusion The lateral lumbar interbody fusion is safe,reliable,and clinically satisfactory for the treatment of lumbar burst fractures,infections,or lumbar anterior and middle column pathology.This method provides new ideas for the treatment of lumbar anterior and middle column pathology.